The Lasting Smile Podcast

‍The Lasting Smile Podcast: Episode 1 Part 2

Discover how precision and technology converge to create long-lasting results in full-arch dentistry. Dr. Frank Lamar and Dr. Julian Conejo continue their deep dive into the digital workflow. This time exploring the art and science of accurately capturing implant positions.‍

Introduction

In Part 2 of The Lasting Smile Podcast, Hybridge Founder Dr. Frank Lamar and Clinical Lab Director Dr. Julian Conejo unpack one of the most critical and often misunderstood steps in full-arch dentistry: the accurate capture of implant positions. From analog impressions to advanced photogrammetry systems, they examine the evolution of accuracy, material tolerances, and how precision at the micron level shapes the longevity of every Hybridge smile.

Here are the 10 biggest takeaways from the conversation.

1. Accuracy Defines Longevity

Full-arch success is built on precision. Even tiny discrepancies measured in microns can create tension, stress, and eventual implant failure. Dr. Lamar reminds clinicians that “a lasting smile” begins with an accurate fit that minimizes mechanical strain over time.

2. Understanding Trueness and Precision

Decades of research now confirm two essential parameters for clinical success: trueness (how close a scan or model is to reality) and precision (how consistently it can be repeated). These principles guide every capture method, whether analog or digital.

3. Analog Impressions: The Old School Standard

The traditional open-tray analog impression still delivers about 80 microns of discrepancy between the master cast and the mouth. While time-tested, this approach relies heavily on clinician skill and introduces variability that can affect long-term passivity.

4. Why Passivity Matters

Implant frameworks must fit passively to prevent hidden tension that leads to screw loosening, fractures, and bone loss. Titanium frameworks can absorb minor inaccuracies due to their flexibility. But newer, stiffer materials like zirconia cannot, making accuracy even more critical.

5. Material Science Meets Clinical Reality

Dr. Conejo explains how different materials react to misfit forces. Titanium “gives” slightly under torque, masking small errors, while ceramic and zirconia frameworks are unforgiving. As prosthetic materials evolve, so must the precision of digital impressions.

6. Intraoral Scanning: The Digital Workhorse

Intraoral scanners like Trios or CEREC PrimeScan have transformed restorative dentistry but remain limited in full-arch capture accuracy. Even the best systems average 50 microns of deviation, making them useful but not ideal for large-span restorations.

7. Photogrammetry: The Gold Standard

Photogrammetry captures implant positions with 10–20 micron accuracy by triangulating the exact 3D coordinates of each fixture. It’s now considered the benchmark for full-arch digital workflows. However, clinicians must still pair it with intraoral scanning to capture soft tissue, bite, and facial data.

8. Grammetry: Bridging the Gap

A hybrid between analog and digital, grammetry combines intraoral scanning with splinted scan posts. These are scanned outside the mouth for greater control and accuracy. It’s an effective compromise for clinicians not yet equipped with photogrammetry units.

9. Selecting the Right System for Your Practice

Dr. Conejo highlights cost-effective, all-in-one systems like the Shining 3D Elite, which integrates intraoral scanning and photogrammetry. For practices doing both single-tooth and full-arch cases, these hybrid systems provide flexibility without major investment.

10. Passivity Isn’t Optional

The episode closes with a reminder that accuracy equals longevity. Whether analog or digital, every method must deliver passivity. As Dr. Lamar summarizes, “Pressure breeds complications and that’s contrary to a lasting smile.”

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The Takeaway

Precision at the micron level isn’t just about technology, it’s about trust. From analog to photogrammetry, each advancement aims to eliminate stress, preserve bone, and ensure that every Hybridge restoration truly lasts.

About the Hosts

Dr. Frank Lamar is the founder of Hybridge and a pioneer in full-arch restorative dentistry.Dr. Julian Conejo is Hybridge’s Clinical Lab Director and a prosthodontist specializing in digital workflows and prosthetic innovation.