Use of prosthesis-generated computed tomographic information for diagnostic and surgical treatment planning

Three-dimensional imaging and guided surgery for dental implants

Clinicians worldwide are increasingly adopting guided surgical applications for dental implants. Clinicians are becoming more aware of the benefits of proper planning through advanced imaging modalities and interactive treatment planning applications. All aspects of the planning phase are based on sound surgical and restorative fundamentals. As an integral part of the implant team, dental laboratories have now moved from analog to the digital world, providing the necessary support to the new digital workflow.

Coverage of denture teeth with tin foil for radiographic guide fabrication

A novel technique using the patient's existing complete dentures as a radiographic guide for diagnosis and treatment planning in implant dentistry is presented. Tin foil is used to cover the denture teeth before the radiographic scan is performed. Advantages of the described technique include its cost-effectiveness, simplicity, efficiency, and lack of need to modify or duplicate the patient's existing dentures. A disadvantage of the technique is that it serves only as a radiographic guide.

A New Twist on Surgical Guides

Surgical guides have evolved to the point that they can be created with the aid of computer-assisted tomography (CT) technology. Surgical guides also are used in construction of the prosthesis prior to implant surgery. With existing guide techniques, the prosthesis is screw retained, or cone-shaped temporary abutments may be used to overcome the lack of parallelism of the implants. With the New Twist technique, we are able to create the surgical guide in such a way that optimum bone may be used and the rotational position of the implant may be established for the surgeon and for the laboratory. Custom abutments are inserted at the time of surgery, as is an esthetic, functionally provisional cemented prosthesis. Castings for the finished ceramo-metal bridge are fabricated before surgery is performed. The final prosthesis then is easily constructed by the restorative dentist during just 3 simple patient visits.

Presurgical Planning With CT-Derived Fabrication of Surgical Guides

As implant dentistry is evolving toward accelerated treatment protocols, with immediate or delayed functional and nonfunctional loading, the importance of presurgical planning becomes paramount. The paradigm for restorative-driven implant placement works best when templates are used to transfer information from the desired plan to the surgical reality. The advent of computed tomography (CT) imaging, and CT-derived surgical templates allow for clinically significant improvements in accuracy, time efficiency, and reduction in surgical error, benefiting the patient, surgeon, restorative dentist, and the laboratory. Continued advances in the state-of-the-art software applications that enable enhanced planning give clinicians the vision necessary to deliver the desired results, while serving as an excellent communication tool between all members of the implant team. This article illustrates the advantages of using CT scan-based templates through various clinical presentations. Procedures were illustrated for single and multiple tooth applications in both mandibular and maxillary arches.

Computer assisted oral and maxillofacial surgery--a review and an assessment of technology

Advances in the basic scientific research within the field of computer assisted oral and maxillofacial surgery have enabled us to introduce features of these techniques into routine clinical practice. In order to simulate complex surgery with the aid of a computer, the diagnostic image data and especially various imaging modalities including computer tomography (CT), magnetic resonance imaging (MRI) and Ultrasound (US) must be arranged in relation to each other, thus enabling a rapid switching between the various modalities as well as the viewing of superimposed images. Segmenting techniques for the reconstruction of three-dimensional representations of soft and hard tissues are required. We must develop ergonomic and user friendly interactive methods for the surgeon, thus allowing for a precise and fast entry of the planned surgical procedure in the planning and simulation phase. During the surgical phase, instrument navigation tools offer the surgeon interactive support through operation guidance and control of potential dangers. This feature is already available today and within this article we present a review of the development of this rapidly evolving technique. Future intraoperative assistance takes the form of such passive tools for the support of intraoperative orientation as well as so-called 'tracking systems' (semi-active systems) which accompany and support the surgeons' work. The final form are robots which execute specific steps completely autonomously. The techniques of virtual reality and computer assisted surgery are increasingly important in their medical applications. Many applications are still being developed or are still in the form of a prototype. It is already clear, however, that developments in this area will have a considerable effect on a surgeon's routine work.