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CT GUIDANCE FOR IMPLANT SURGERY

CT GUIDANCE FOR IMPLANT SURGERY. Treatment Advancement? Marketing Ploy?. 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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CT GUIDANCE FOR IMPLANT SURGERY

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  1. CT GUIDANCE FOR IMPLANT SURGERY

  2. Treatment Advancement? Marketing Ploy?

  3. 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

  4. 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

  5. Treatment Protocol Photo courtesy iDent Disclaimer: Neither Dr. Rotter nor Dr. Blackwell have any monetary interest in the corporations identified in this presentation.

  6. Photo courtesy iDent

  7. 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

  8. Good quality alginate impressions Must capture sulcus areas buccally and lingually Full palate is needed when implants placed in maxilla CT Guide Photo courtesy iDent

  9. Teeth are set up on the model in the edentulous areas in the ideal position for prosthetic restoration CT Guide Photo courtesy iDent

  10. Fully Edentulous: Shape of complete denture Extends to sulcus areas Complete palatal coverage CT Guide Photo courtesy iDent

  11. Partially Edentulous: Extends into sulcus area Covers occlusal/incisal surfaces of remaining teeth Covers buccal/labial surfaces approx. 3mm CT Guide Photo courtesy iDent

  12. The shape of the CT guide is made in wax and a mold is made from putty impression material CT Guide Photo courtesy iDent

  13. Wax is removed with hot water Acrylic injected into mold CT Guide Photo courtesy iDent

  14. 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 CT Guide Photo courtesy iDent

  15. Pin location is used to predict surgical locations Software can automatically place implant in the location of each pin CT Guide Photo courtesy iDent

  16. 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 CT Guide Photo courtesy iDent

  17. It is essential that there are EXACTLY 6 markers, no larger than 1mm in diameter. This is necessary to allow the software to combine the 2 scans of the CT guide

  18. Try in prior to CT scan Intimate fit with no rocking CT Guide Photo courtesy iDent

  19. Handmade CT Guide – TO-- Digitally manufactured surgical guide CT Guide/Surgical Guide Photo courtesy iDent

  20. Photo courtesy iDent

  21. Photo courtesy iDent

  22. Photo courtesy iDent

  23. Photo courtesy iDent

  24. Photo courtesy iDent

  25. Photo courtesy iDent

  26. Photo courtesy iDent

  27. If possible, leave at least 1-2 teeth to help stabilize surgical guide, even if these teeth will be extracted after implant placement. Surgical Guide Photo courtesy iDent

  28. Photo courtesy iDent

  29. Photo courtesy 3i

  30. Photo courtesy 3i

  31. If you have an interest in obtaining a copy of the interactive used in this presentation, please email Dr. Rotter at brotter@siue.edu

  32. Photo courtesy 3i

  33. 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 brotter@siue.edu

  34. Summary TOOL E START SMALL R GAIN EXPERIENCE E PLANNED PROCEDURES WORK BEST

  35. THANK YOU!

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