Surgery planning and dental restoration by means of an accurate surgical guide are the principles of navigation implantology. In this case a surgeon, dental technician, and orthopedist closely work together, which excludes unpleasant inconsistencies at the stage of prosthetic treatment. And, of course, the risk of unsuccessful implantation and nonaesthetic restoration is reduced.
|Pic. 1. The consequences of unsuccessful implantation planning|
Reduction of unsuccessful implantation risk
The main reason of using implantation templates is safety. The template can be supported by teeth, gums or bones; the drill thickness and the implant depth are limited. 3D-planning and implantation placement by means of a surgical guide help to prevent:
1. Perforation of a maxillary sinus
Pic. 2. Natural perforation of a maxillary sinus
Pic. 3. Perforation of a maxillary sinus.
(The picture by the Dental Club)
2. A mandibular nerve damage
Pic. 4. A mandibular nerve on a 3D-dummy
3. Perforation of a cortical plate by an implant or drills
4. Inconsistency of an implant axis and an orthopedic construction axis
|Pic. 5, 6. Inconsistency of an implant axis and an orthopedic construction axis|
Pic. 7. Periimplantitis caused by wrong implantation planning
It is also possible to prevent various consequences of a wrong implant position in a bone outside of a dental arch.
The possibility of forecasting for both operative and orthopedic stages
The latest method of the template making takes into account both the jaw CBCT and the results of intra-oral scanning or scanning of a gypsum model of a human jaw. This method allows also to determine the type of the bone in the defect zone, predict the precise position of the implant in the bone, as well as the position and view of the abutment and crown after placement. This all provides accurate prognosis.
This is especially needed at one-stage implantation, which is as popular among patients now as never. Patients come to a dental office and wish to have a beautiful smile immediately.
|Pic. 8. Virtual implantation planning in a software|
While using the implantation planning system it is also possible to conduct virtual tooth extraction.
|Pic. 9. Virtual tooth extraction|
It is also possible to make temporary or permanent restoration before the surgery.
This is how close cooperation of an orthopedist, dental technician, and surgeon becomes possible, which helps to solve the issue of the dental office stuff interaction.
The world-known implant systems developed their own implantation planning systems. Such developers of CAD/CAM equipment and software also create their own universal solutions for implantation planning and surgical template making.
On the pictures you will see how 3D implantation planning is visualized in various software.
|Pic. 10, 11, 12, 13, 14. 3D implantation planning|
Implantation planning stages
There are only four conditions for successful surgery with an implantation template using:
- Cone beam CT with radiologic navigation or without it;
- Intra-oral scanning or scanning of a gypsum model;
- A virtual dummy of template for its further making;
- A virtual dummy of a temporary or permanent orthopedic construction;
First of all, it is necessary to examine the patient to find the best solution for the case. Depending on the circumstances, the movable system could be suitable as well.
Making of an implantation template
On the basis of the scanning data and the implantation plan created in the software the surgical template for implantation is made.
- If you have used the system 3SHAPE, the prognosis accuracy reaches 95% and more.
- The method of 3D printing is the most progressive, it allows to make a highly accurate template necessary for one-stage implantation.
- The best template is the one that has guided sleeves. Screw fixation can be used for higher stability.
|Pic. 15. A dummy of a surgical template with guided sleeves|
Instead of the conclusion
A great advantage of navigation implantology is a surgery conducted according to a clear plan at any stage. No doubts, patients would like to know how they will feel after the procedure is completed, as well as how their teeth will look. It is impossible to get a distinct reply without assessment of the quantity of teeth, gums, and bones they lost. All this can be seen in a 3D dummy.
We can also explain to a patient what results of all the actions within the implantation process will be. We can do it directly on wax up or by showing CBCT with virtual implants and teeth.