DENTAL TECHNIQUE

Transferring the tooth preparation finish line on intraoral

digital scans to dental software programs: A dental technique
Guillermo Cabanes-Gumbau, DMD, PhD,a Juan Carlos Palma, RDT,b John C. Kois, DMD, MSD,c and
Marta Revilla-León, DDS, MSD, PhDd

Intraoral scanners (IOSs) now ABSTRACT

provide a recording method for Intraoral scanner software programs allow the clinician to draw the tooth preparation finish lines.
fabricating tooth- and implant- However, this information may be lost when importing the digital file into different computer-
supported crowns and fixed aided design (CAD) dental software programs. A technique for transferring the marked tooth
partial dentures (FPDs).1-6 The preparation finish line into an intraoral digital scan is described. The intraoral digital scan of the
software programs provided tooth preparation is duplicated and used to draw the finish line. Subsequently, the tooth
with IOSs facilitate acquisition preparation geometry is erased while maintaining the finish line border, which will be used as a
reference when designing the definitive restoration in the CAD software program. (J Prosthet
by allowing real-time three-
Dent 2023;130:439-43)
dimensional (3D) visualization
and providing tools to edit the
scan. These tools allow the clinician to trim the scan, zoom This article describes a technique for transferring the
in on a specific area, or block the scan to avoid further identified tooth preparation finish line from an intraoral
modifications. Furthermore, IOS software programs digital scan to the CAD software program. The intraoral
simplify clinical treatment with assessment tools that help
the clinician evaluate tooth preparations by determining
the path of insertion, detecting the presence of undercuts,
assessing the amount of interocclusal space, and identi-
fying the finish line.
In conventional impression techniques, the location of
the preparation finish line is typically performed on the
definitive stone cast by the dental laboratory technician.
The incorporation of IOSs can facilitate the communi-
cation between dental professionals by completing the
finish line identification in the intraoral digital scan by
using the IOS software tools and then transferring those
data to the CAD dental program. However, if the IOS
device and the CAD software program are from different
manufacturers, the identified finish line will not be
included in the CAD software program. Figure 1. Mandibular left first premolar with interim crown.

a
Private practice, Vila-real, Spain; and Director BOPT Technique Expert, La Salle University, EDE Formación, Madrid, Spain.
b
CEO DentalCAD Academy, Madrid, Spain.
c
Founder and Director Kois Center, Seattle, Wash; and Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle,
Wash; and Private practice, Seattle, Wash.
d
Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; and Director of
Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Associate Professor, Prosthodontic Department, Tufts University, Boston, Mass.

THE JOURNAL OF PROSTHETIC DENTISTRY 439

440
Figure 2. Intraoral digital scan of tooth preparation.
Figure 4. Deleted tooth preparation coronal to marked finish line by using the “trim” tool of intraoral scanner software program. A, Partially deleted. B,
Completely deleted.
digital scan of the tooth preparation is duplicated and
used to draw the finish line. Subsequently, the tooth
preparation geometry is erased while maintaining the
finish line border, which will be used as a reference when
designing the definitive restoration in the CAD software
program.
TECHNIQUE
A patient receiving a mandibular left first premolar crown
was selected to illustrate the technique.
1. Obtain an intraoral digital scan of the mandibular
arch with the existing interim crown on the
left first premolar, maxillary arch, and max-
illomandibular registration by using an IOS (3600
CS; Carestream) during the first clinical appoint-
ment. Follow the scanning protocol endorsed
by the manufacturer under optimal ambient light
illuminance conditions (Fig. 1).7,8 Remove the
THE JOURNAL OF PROSTHETIC DENTISTRY
Volume 130 Issue 4
Figure 3. Drawing of tooth preparation finish line on duplicated intraoral
digital scan by using “margin line” tool of intraoral scanner software
program.
interim restoration, and clean the tooth prepara-
tion. Then, obtain an intraoral digital scan of the
preparation (Fig. 2). Export the STL file and label it
STLinitial.
2. Duplicate the intraoral digital scan that contains the
tooth preparation, and draw the tooth preparation
finish line on the duplicated scan by using the
“mark margin” tool of the IOS software program
(Fig. 3).
3. Delete the tooth preparation coronal to the marked
finish line by using the “trim” tool of the IOS
software program (Fig. 4). Export the file as
STLmarked.
4. Submit both the STLintial and STLmarked files to the
dental laboratory or import them into a CAD soft-
ware program (DentalCAD 3.0, Galy; exocad). The
mandibular scans have the same orientation in the
x-, y-, and z-axes, and, therefore, both mandibular
scans will already be aligned (Fig. 5). The dental
Cabanes-Gumbau et al
October 2023 441

Figure 5. A, Tooth preparation intraoral digital scan. B, Modified intraoral digital scan that contains tooth preparation finish line information. C, Aligned
intraoral digital scans. D, Interim restoration intraoral digital scan.

Figure 6. CAD procedures. A, Digital scan with tooth preparation finish line marked. B, Aligned intraoral digital scan and marked tooth preparation finish
line scan. C, Marking finish line of definitive restoration by using tools of CAD software program. Pink line represents marked tooth preparation finish line
determined by clinician by using tools of intraoral scanner software program, while green line represents finish line of definitive restoration determined by
dental laboratory technician by using tools of CAD software program. D, Finish line of definitive restoration. CAD, computer-aided design.

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442 Volume 130 Issue 4

Figure 7. Representative example of described technique for implant-supported crown. A, Intraoral digital scan of implant and adjacent tissues. B,
Drawing of desired gingival contours of implant-supported restoration. C, Modified intraoral digital scan containing desired gingival contours of
implant-supported restoration. D, Aligned maxillary intraoral digital scans. E, Drawing of desired gingival margin location in implant abutment.

professional can visualize the marked tooth prepa- DISCUSSION

ration finish line by using the trimmed duplicated
scan (Fig. 6A, 6B).
5. Determine the finish line of the definitive restora-
tion by using the marked tooth preparation finish
line as a reference (Fig. 6C, 6D). Complete the
design of the definitive dental restoration by using
the tools of the CAD software program as
customary (Video 1).
The described technique simplifies communicating the
desired tooth preparation finish line to the dental labo-
ratory technician. The procedure is straightforward and
does not require additional hardware or software pro-
grams; furthermore, it can be performed in any IOS
system that allows marking of the tooth preparation
finish line and includes trimming tools in the IOS

THE JOURNAL OF PROSTHETIC DENTISTRY Cabanes-Gumbau et al

October 2023
software program. The main advantage is the simplicity
that permits communication between the clinician and
dental laboratory technician, even if they use different
manufacturers for their respective IOS systems and
dental CAD software programs.
Determination of the tooth preparation finish line is a
critical step when designing and fabricating tooth-
supported prostheses, particularly when using the biolog-
ically oriented preparation technique (BOPT).9,10 Unlike
horizontal preparation techniques, the BOPT involves a
vertical tooth preparation in which the tooth preparation
finish line may be positioned at different levels inside the
gingival sulcus (to a depth of 0.5-1 mm) without affecting
marginal adaptation (as there is a finishing area instead of
a distinct finish line).9,10 The described technique should
ease the fabrication process and maximize the digital tools
available for dental professionals.
The trimming tool of the IOS software program is
user friendly; however, trimming the border is not as easy
as marking of the tooth preparation finishing line with
the “margin mark” tool. This could be explained by the
functionality differences between the two software pro-
gram tools. The intraoral digital scan is a triangle mesh;
therefore, the trimming border is determined by the tri-
angle junction borders. This limitation would be over-
come if the software manufacturers were to add
additional editing tools into the IOS software program.
The described technique could be also adapted for use
with implant-supported prostheses to transfer the gingival
contours and the gingival margin location of the implant
abutment. Similarly, an intraoral digital scan obtained
without the implant scan body or without the healing
abutment can be duplicated and used to mark the gingival
contours to guide the dental laboratory technician in
fabricating the implant-supported restoration (Fig. 7).
SUMMARY
This article describes a technique for transferring a
marked tooth preparation finish line from the intraoral
digital scan to the CAD software program. The intraoral
Cabanes-Gumbau et al
443
digital scan of the tooth preparation is duplicated and
used to draw the finish line. Subsequently, the tooth
preparation geometry is erased while maintaining the
finish line border, which can be used as a reference when
designing the definitive restoration in the CAD software
program.
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Corresponding author:
Dr Marta Revilla-León
1001 Fairview Ave N # 2200
Seattle, WA 98109
Email: marta.revilla.leon@gmail.com
Copyright © 2021 by the Editorial Council for The Journal of Prosthetic Dentistry.
https://doi.org/10.1016/j.prosdent.2021.10.009
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