Tag Archive for 'GuidedSurgery'

Simple and Economical yet guided…


Couple of decades ago there was the osseointegration revolution.  Then there was the bone grafting one.  The last decade has been all about two topics:  Soft tissue management in the esthetic zone and Guided implant placement. Guides are pretty common place today but not ubiquitous, although they should be.  Of course implants can be and are placed without guides.  But if given a chance everyone would like to have a guide for ease of placement and greater accuracy.  Then why don’t they?  Mainly due to the additional cost and the complexity of working up the case using software.  Well instead of having simplant or other CAD/CAM type guides made.  Here is a guided case done with a local lab.  The guide was made to the size of the final drill (nobel 4.5mm in this case).  The telescoping pieces slide in and out to make the drill hole 2mm and 3.5mm in diameters for the intermediate drills.  The precision placement allowed me to place this implant and immediately load it with a screw retained temporary crown for ideal soft tissue contours.  The cost of the guide – $100.  The two telescoping pieces are autoclavable and reusable for multiple cases.  No need for the guided kits from nobel or straumann, etc.  You can just use your normal surgical kit.



Outsource your treatment planning…

I just treatment planned a four implant, truly guided case – over the phone. The most brilliant thing was that the person on the other end was halfway across the world! The world is indeed flat. I have been using an iCAT to place implants since we got one in 2004. I used iCAT vision, the software that came packaged with the machine. This gave a lot of information but did not allow me to do virtual surgery on the images (i.e. place mock implants where they should go). I started doing this with the third party software, Keystone Dental’s EasyGuide.

Last month I came across a company 3D Diagnostix based out of Boston. Theirs is a truly brilliant concept. You send them the iCAT and they do the treatment planning (by a qualified surgeon). Then you have a meeting with them over the web to verify that you like the plan. You can also involve the restorative dentist and the lab in this. I gotta tell you it is kind of cool to just have to tell someone over the phone where you want to move the implant to, and a second later it’s done right there on your screen. The whole process has been seamless so far. Very impressive! The concept here is to basically outsource your treatment planning as you would your accounting or your lab work but still retain complete control over it. Once approved a surgical guide is fabricated and mailed to you!