Collecting Records

Collecting Records | Intraoral Scanning

What are the benefits of intraoral scanning?

1. It's more comfortable for patients than conventional impressions. 
2. It saves costs on impression materials. 
3. There are no shipping hassles. 
4. Facilitates sending scans to ClearCorrect electronically, resulting in a faster turnaround. 
5. It is more time efficient and simplifies clinical procedures. 
6. It has higher or comparable accuracy compared to traditional impressions.
7. There is a 7x decrease in aligner fit issues when models are made with intraoral scanning. 
8. A 22% reduction of remakes.
9. 80% of offices delegate some or all scanning to their assistants.

Collecting Records | Dental Impression

The importance of quality impressions.

The fabrication of ClearCorrect aligners firstly requires the submission of high-quality impressions of the patient's teeth and gingiva.

Submitted PVS impressions are scanned by the ClearCorrect CT scanners to produce a digital file, which is then 'printed' into digital models of the patient's dental anatomy. The aligners are then fabricated directly on the models designed to transform the malocclusion into the finished treatment result prescribed by the doctor.

The accuracy of the precise fit of the aligners when delivered to the patient begins with the accurate capture of the patient's dental anatomy. There cannot be any defects, distortions, or anomalies in either the digital or PVS impressions that may be transferred to the digital models. 

Whether the dental practice is submitting PVS or digital impressions, the individual taking the impressions must be well-trained and disciplined to submit high-quality impressions for each case.

Collecting Records | Intraoral Scanning

On-screen now you can see the eight key steps of traditional case workflow using PVS impressions.

→Intraoral Scanning | Digital Workflow

Overall, this reduces the number of steps to just five and will save between 3 to 5 days!

While scanning you may come across a few issues that you need to be aware of.

→Intraoral Scanning | Holes in The Scan

Description: Data void in the upper and/or lower arch scans. 

Causes: Data voids are caused when the intraoral scanner fails to capture the tooth or tissue anatomy. 

How to avoid: Make sure to stay on the tooth long enough so that the full tooth can be captured. Check the scan to make sure no anatomy is missing before moving to the next quadrant.

→Intraoral Scanning | Missing Gingiva

Description: Minimal material in the gingival region. 

Causes: Missing gingiva is caused when the intraoral scanner fails to capture the gingival region. 

How to avoid: Make sure to rotate the intraoral scanner to the gingiva to capture the full gingival region and gum line. Check the scan to make sure 3-4 mm of the gingiva is captured, before moving to the next quadrant.

→Intraoral Scanning | Excess Material

Description: Excess material attached to the teeth. 

Causes: Excess material is caused when not enough tooth surface is captured, so the scanner software compensates by adding excess material. 

How to avoid: Make sure to stay on the tooth long enough so that the full tooth/teeth can be captured. Check the scan to make sure no anatomy is missing, before moving to the next quadrant.

→Intraoral Scanning

1. Visually inspect your STL file for data 'voids' before submitting. 
2. Scan both arches, even if you're only treating or revising one of them. Recreating the occlusion based on one arch is prone to error. 
3. Include a scan of the patient's proper occluded bite. 
4. To assure the proper height of the Trimline, always capture at least 3-5 mm of tissue above the gingival margin in the scan. 
5. Capture more accurate bite scans by including as much of the occlusion as your scanner allows.

For most scanners, there are three main steps:

Step 1: CREATE THE .STL FILE

• Using the scanner of your choice, scan the patient. 
• Either export the scans by direct integration (if offered for your scanner) or export as .STL files by following the process for your scanner, and save in a location (determined by you) on your computer. 
• Be sure to save both the upper and lower scan files with the arches oriented in occlusion.

Step 2: CREATE THE CASE IN THE DOCTOR PORTAL

• Go through the steps to create a case in the Doctor Portal. 
• When uploading the scans, select the scanner used (if listed) or the "other STL" option. 
• Click in the box to upload the STL files you created and saved.?

Step 3: SUBMIT THE SCAN

• Finish submitting the case by providing the information for the remaining steps in the submission process. 
• Check the boxes indicating you have obtained the Patient Informed Consent, agree to the Terms & Conditions, and accept Straumann Groups Privacy Policy. 
• Click "SUBMIT". 

Collecting Records | PVS Impressions

What are the requirements for PVS impressions?

Step 1: You will need both upper and lower impressions, even if you are only treating one arch.

Step 2: Bite registrations are optional.

Step 3: Disposable trays are best (mesh or metal trays are unacceptable).

The trays must fit all teeth in the arch and cover the surrounding gums 4 mm beyond the zenith of the gingival margin. They must extend beyond the distal of the terminal tooth.

What Material will you need?

Any Silicone-based Impression Material PVS or VPS materials are best. Alginate is not acceptable because it dries out and distorts.	Heavy body impression material
Light body impression material	Adhesive
Trays	A Timer

We have some top tips when gathering your PVS Impressions.

Tip: Performing a cleaning before taking the impressions removes plaque which can make for better impressions and could reduce the amount of residual spacing at the end of treatment.

Tip: Dry the teeth with the air syringe to eliminate saliva bubbles interfering with the details of the impression.

Tip: Be sure to remove all engagers before taking impressions. When impressions are taken with engagers still attached to the patient's teeth, there is a possibility of the engager tearing the impression when removed which can cause damage to the impression.

Tip: One-step impression techniques seem to get the best results (but we'll accept two-step impressions as well).

Tip: When applying the light body material on top of the heavy body, it is best to avoid lifting the tip of the applicator. This will help prevent bubbles from forming in the impression.

Tip: The most common mistake when taking impressions is removing the trays when the material hasn't been fully set.

1. Set a timer and make sure to follow the directions for your material exactly 
2. Discard the first inch of material that comes out of every new mixing tip.
3. We suggest waiting an additional 60-90 seconds longer than instructed before removing the trays from the patient's mouth.

Tip: A common issue when taking impressions is getting distal of the last molars-it can be difficult to get a good impression since it's hard to see back there.

1. Make sure that you're using a correctly-sized tray. It should extend past the last tooth in the arch without touching the gums. 
2. Before inserting the tray containing the light body, add some light body directly to the occlusal and distal portion of the last tooth in the arch, ensuring that the last tooth is completely covered with impression material.

Once you've taken your impressions before you send them in, look at the impression and make sure:

Radiographs

Let's take a look at some helpful examples of radiographs.

Please Note: X-Rays are NOT required.

Please Note: X-Rays are NOT required.

Check for imperfections in the material that compromises the dental anatomy.

Voids: Insufficient material creates a void in the impression, preventing us from capturing the actual tooth outline.

Bubbles: This occurs while the impression material is being distributed, due to the tip being lifted out of the material. Pulling the tip out creates a hollow void that, when more material is distributed on top of it, creates a bubble.

Thin walls: Thin walls are created in a number of ways: insufficient material, too small trays, or the tray was pushed in too deep. The material itself captures the majority of the tooth anatomy, however, the scanning process does not pick up the tray well leaving that much of the tooth anatomy incomplete or distorted.

Shifts: The tray shifted while the impression material was still setting, creating a double margin on a few teeth.

Double Imprints: When the full arch or quadrant was shifted, normally occurring during a two-step impression.

Pulls: When the impression material starts to prematurely set before it's placed in the patient's mouth it results in a "pulled" effect around the gingival margin.

Tears: Tears occur when the patient has extreme undercuts or black triangles which causes the impression material to lock into the interproximal and tear when removing the impression.