• Aim

• Clinical indication

• Manufacturing scan prosthesis

• CT scan protocol

• Double scan registration wizard

Double scan

• Visualize tooth setup within CT imagesImplant planning can be based on both clinical and aesthetic considerations

• Visualize mucosa surfaceNecessary for manufacturing of mucosa-supported SurgiGuide

Aim

Fully edentulous cases– Maxilla– Mandible

Clinical indication

• Good fitting removable dentureNo air between gingiva and prosthesisto avoid

=> false indication mucosa thickness

=> malfitting mucosa-supported SurgiGuide

• Prosthesis– Material: acrylic resin– No radio-opaque teeth– No metallic parts– Base plate minimally 2 mm thick

Manufacturing scan prosthesis

• Markers– Radio-opaque material

(e.g. gutta-percha, Titanium, Cavit®)

– Shape: spherical– Dimensions: app. 2 mm diameter– Number: 8 (4 -15) – Good distribution

• Spread over entire prosthesis• Some close to tooth-gingiva border• Some close to outer border prosthesis

Manufacturing scan prosthesis

• CT-scan of patient– Patient must wear the scan prosthesis– Positioning in scanner

CT scan protocol

Conventional CTCone Beam CT

• CT-scan of patient– Image range

CT scan protocol

Conventional CT Cone Beam CTMaxilla

• CT-scan of patient– Image range

CT scan protocol

Conventional CT Cone Beam CTMandible

• CT-scan of patient– Scan parameters

CT scan protocol

Matrix 512 x 512

Field of View 140 – 170 mm

Slice thickness 0.5 mm (max. 1.0 mm)

Feed per rotation 1.0 mm

Reconstructed slice increment 0.5 mm (max. 1.0 mm)

Reconstruction algorithm Bone or high resolution

Gantry tilt 0°

• CT-scan of prosthesis– Positioning in scanner

Similar as positioned in patient’s mouth

CT scan protocol

Maxilla Mandible

Conventional CTCone Beam CT

• CT-scan of prosthesis– Fixation of prosthesis in scanner

Use only radiolucent materialAt least more radiolucent than prosthesis

itself– Image range

Full prosthesis- Scan parameters

At least same as for patient scan, But higher resolution is allowed

CT scan protocol

• Import scan of patient• Scan registration wizard

Double scan registration wizard

Adapt box to only include radio-opaque markers!

ORDICOM images of scan of prosthesis

preferably in separate folder!

• Import scan of patient• Scan registration wizard

Double scan registration wizard

Possible to changethreshold for prosthesis

Possible to adapt box toonly include prosthesis