Highly precise 3D imaging and implant surgery planning has made implant placements faster and highly predictable. Advanced tools are used by the dentist to analyze the quality and quantity of the jaw bone where the implant is being placed. This helps in placing implant faster and easy by saving money. It is always said to get a dental implant by highly skilled clinician.
Dangers of dental implant include:
- Infection at the implant site.
- Damage to never causing paresthesia/ numbness in the cheek.
- Injury to surrounding structures like tissues and periodontium.
- Sinusitis or sinus perforation is the common risk associated.
Dr. Sachdeva’s dental implant clinic in North Delhi is highly equipped with advanced instrumentation. Using 3D imaging system while treatment planning makes it easy to minimize the above dangers, associated. Dr. Rajat is the best dental implant doctor in Delhi; continuing to place successful dental implants with patients from different countries and within.
Use of various implant guides in the surgery
Surgical guide template fabrication involves a diagnostic tooth arrangement through one of the following ways:
- A diagnostic waxing.
- A trial denture teeth arrangement.
- The duplication of a preexisting dentition/restoration.
The fabrication of the surgical guide templates is then based on one of the following design concepts.
- Non-limiting design.
- Partially limiting design.
- Completely limiting design.
These design concepts are classified based on the amount of surgical restriction offered by the surgical guide templates.
- Non-limiting designs only provide an indication to the surgeon as to where the proposed prosthesis is in relation to the selected implant site. This design indicates the ideal location of the implants without any emphasis on the angulation of the drill, thus allowing too much flexibility in the final positioning of the implant.
- In such designs, the first drill used for the osteotomy is directed using the surgical guide, and the remainder of the osteotomy and implant placement is then finished freehand by the surgeon. Techniques based on this design concept involve fabrication of a radiographic template, which is then converted into a surgical guide template following radiographic evaluation.
- Completely limiting design restricts all of the instruments used for the osteotomy in a buccolingual and mesiodistal plane. Moreover, the addition of drill stops limits the depth of the preparation, and thus, the positioning of the prosthetic table of the implant. As the surgical guides become more restrictive, less of the decision-making and subsequent surgical execution is done intraoperatively. This includes 2 popular designs:
-
- Cast-based guided surgical guide: The surgical guide is a combination of an analog technique done along with bone sounding and the use of periapical radiographs in a conventional flapless guided implant surgery. The periapical radiograph is modified using digital software to help in transposition of root structure onto the cast. The cast is then sectioned at the proposed implant site, and bone-sounding measurements are transferred to help in orientation of the drill bit to perform a cast osteotomy. A laboratory analog is placed in the site, and a guide sleeve consistent with the implant width is modified using wires that are used to create a framework around the teeth. Vinyl polysiloxane occlusal registration material is used to form the superstructure
-
-
-
- Computer-assisted design manufacturing (CAD/CAM) based surgical guide: CAD/CAM technology uses data from computerized tomography scan (CT) to plan implant rehabilitation. The CT images are converted into data that are recognized by CT imaging and planning software. This software then transfers this pre-surgical plan to the surgery site using stereolithographic drill guides. CAD/CAM-based surgical guides offer many advantages. For example, the virtual 3D views of the bony morphology allow the surgeon to visualize the surgical bone site prior to implant placement; risks such as inadequate osseous support or compromise of important anatomic structures are avoided; incorporation of prosthetic planning using a scanographic template allows the treatment to be optimized from a prosthodontics and biomechanical point of view; and the technique promotes flapless surgeries, allows pre-surgical construction of the master cast and provisional restorations, and facilitates immediate loading.
-
Accuracy of CAD/CAM technology in dental implant planning and predictable transfer of the pre-surgical plan to the surgical site has been documented. However, the effectiveness has not yet become an established fact and still needs ongoing research. This technique has certain drawbacks. Special training for familiarity with the entire system and special equipment is necessary. The procedure for fabrication of CAD/CAM based surgical guides can be divided into the following steps:
- Fabrication of the radiographic template.
- The computerized tomography scan.
- Implant planning using interactive implant surgical planning software.
- Fabrication of the stereolithographic drill guide
