Download - CT GUIDANCE FOR IMPLANT SURGERY
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CT GUIDANCE FOR IMPLANT SURGERY
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Treatment Advancement?Marketing Ploy?
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WHY USE CT GUIDANCE?• Precise surgery• Time savings• Avoidance of critical structures• Avoidance of grafting/prior knowledge of
graft necessity• Tooth site placement• Implant parallelism • Immediate provisionalization
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Why Not?
• NOT for every case• NOT a substitute for surgical training and
experience• NOT a way to avoid treatment planning
decisions• NOT an automated decision maker
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Treatment ProtocolDisclaimer: Neither Dr. Rotter nor Dr. Blackwell have any monetary interest in the corporations identified in this presentation.
Photo courtesy iDent
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Photo courtesy iDent
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CT Guide
• Mandatory FIRST step in planning CT guided implant procedures
• Simple to construct• Must be made EXACTLY according to
protocol in order to accurately produce the surgical guide
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CT Guide
• Good quality alginate impressions
• Must capture sulcus areas buccally and lingually
• Full palate is needed when implants placed in maxilla
Photo courtesy iDent
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CT Guide
• Teeth are set up on the model in the edentulous areas in the ideal position for prosthetic restoration
Photo courtesy iDent
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CT Guide
• Fully Edentulous:– Shape of complete
denture– Extends to sulcus
areas– Complete palatal
coveragePhoto courtesy iDent
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CT Guide
• Partially Edentulous:– Extends into sulcus
area– Covers occlusal/incisal
surfaces of remaining teeth
– Covers buccal/labial surfaces approx. 3mm
Photo courtesy iDent
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CT Guide
• The shape of the CT guide is made in wax and a mold is made from putty impression material
Photo courtesy iDent
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CT Guide
• Wax is removed with hot water
• Acrylic injected into mold
Photo courtesy iDent
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CT Guide
• Made from clear acrylic, approximately 3mm in thickness
• MUST BE RIGID• NO VACUFORM• No Barium is used• Metal pin placed in
the center of each missing tooth
Photo courtesy iDent
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CT Guide
• Pin location is used to predict surgical locations
• Software can automatically place implant in the location of each pin
Photo courtesy iDent
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CT Guide• 1mm round drill used
to drill 6 holes approx. equally spaced in the lingual or palatal side of the CT guide.
• Holes should be far from the teeth
• Gutta Percha compressed into holes, and covered with acrylic
Photo courtesy iDent
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It is essential that there are EXACTLY6 markers, no larger than 1mm in diameter. This is necessary to allow the software to combine the 2 scans of the CT guide
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CT Guide
• Try in prior to CT scan– Intimate fit with no
rocking
Photo courtesy iDent
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CT Guide/Surgical GuideHandmade CT Guide – TO-- Digitally manufactured
surgical guide
Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy iDent
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Surgical Guide
• If possible, leave at least 1-2 teeth to help stabilize surgical guide, even if these teeth will be extracted after implant placement.
Photo courtesy iDent
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Photo courtesy iDent
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Photo courtesy 3i
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Photo courtesy 3i
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If you have an interest in obtaining a copy of the interactive used in this presentation, please email Dr. Rotter at [email protected]
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Photo courtesy 3i
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Surgical Procedure and Temporization
If you have an interest in obtaining a copy of the video used in this presentation, please email Dr. Rotter at [email protected]
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Summary
TOOL E
START SMALL R
GAIN EXPERIENCE E
PLANNED PROCEDURES WORK BEST
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THANK YOU!