CATEGORY 66 AUSTRALASIAN DENTIST LINICAL Solutions featured: 3Shape TRIOS intraoral scanner 3Shape TRIOS Design Studio – open chairside solution Case information The patient, a female age sixty-three, attended as a new patient at the practice requesting orthodontic treatment and restoration of her dentition which had multiple failing posterior restorations. This case study focuses on the upper right first molar which has a large amalgam restoration with secondary caries present, the patient requested a more aesthetic restoration to replace this and understood the need for cuspal coverage to protect the remaining tooth tissue. Treatment plan For the treatment, it was decided to use a lithium disilicate onlay to provide cuspal protection whilst minimising the amount of tooth surface removed to prepare the tooth. This is carried out using a full digital workflow and direct integration between the 3Shape TRIOS Design Studio and the DGShape DWX-42W mill to allow for in house manufacture of the restoration The upper right first molar responded positively to vitality test and there is no sign of apical pathology on radiographic examination. Fig. 1 (i, ii) Case setup in TRIOS Design Studio as an inlay/onlay indication. Fig. 2 (i, ii) The virtual articulator in the software is run and the design adapted to remove any working side and non-working side interferences. Fig. 7 (i, ii) Onlay for upper right molar using chairside workflow with TRIOS Design Studio By Dr. Douglas G Watt, Royal Leamington Spa Fig. 1 (ii) Fig. 1 (i) Fig 2 (i) Fig. 2 (ii) Fig. 4 Fig. 5 Fig. 6 Fig. 7 (i) Fig. 3 Following the software’s guided workflow, the margin line and insertion direction are defined and adjusted as necessary. Fig 3 Identification of the margin line is aided by the use of an HD overlay photo taken with the 3Shape TRIOS at the time of scanning. Fig. 4, 5 Onlay design proposed by 3Shape TRIOS Design Studio software and adjusted as necessary to place occlusal contacts and interproximal contact point as required with the preferred level of contact between the teeth and abide by the set minimal thickness in line with manufacturer recommendations. Fig. 6
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