Digital technology has already abundantly embraced multiple aspects of our everyday life. This is definitely involving the dental world as well. Digital Radiograph devices, digital impressions, digital photography, digital manufacturing of prosthetic devices as well as dental implant planning software are more and more commonly utilized by general dentists and specialists.

Digital dentistry may be defined as any dental technology or device that replaces manual activity with digital or computer-controlled activities. In this sense, speed and precision are most of the time achieved in a more predictable way, decreasing human error.

Most digital devices help the restorative dentist to shorten the dental appointment, decrease the use of dental material and increase the precision of the prosthetic products. Along this rationale, digital dentistry was developed to favor surgeon’s procedures too. Nowadays, dental implant software is very used by clinicians to simplify complex cases and increase the speed of regular ones. Yes, this is not the main reason why the introduction of digital implant software revolutionized implant dentistry.

The most important advantage for surgeons and restorative dentists is that implant software has the feature to pre-visualize the final location of the implant when matched to a radiographic image or a dental digital impression.

First, a 3D radiograph (CBCT) of the patient is obtained. The radiologist can identify pathologies and clear the case for implant therapy. The joint analysis of surgeon and prosthodontist is then crucial for the definition of implant number and location.

A digital dental impression of the patient’s teeth can be obtained with a digital scanned. The file can then be uploaded in the implant software and matched with the same patient’s CBCT. At this point the clinician can visualize the bone sections of the patient as well as the teeth shown by the dental impression.

The prosthodontist usually completes this picture by adding the future teeth design requested or planned for this patient. After these steps, the computer monitor will show a combination of superimposed images that represent the real clinical scenario of the patient. With the dedicated software tools, the clinicians can now move and adapt the dental implants on the images above mentioned.

The great advantage of this process is to know in advance where, how many and how an implant can be placed, which surgical complications may arise and a visual guide for the surgical procedure itself. After this plan, the clinician can fabricate a physical device that can capture the location of the planned implants and make it reproducible.

Thanks to other digital software, the dentist can digitally draw a “surgical guide” for implant placement and fabricate it thanks to specific machinery connected to the planning software.

Fig. 1. Digital scan of the dental impression of the patient.

Fig. 2. Radiographic sections with the planned implant (in blue) positioned on the ideal crown restoration location. Lateral and frontal view of the jaws of the patient in order to control the correct angulation of the implant in all directions.

The final device will reproduce precisely the location of the implant that were just planned. The case now can be executed by the surgeon that will apply this device in the mouth of the patient and perform the surgery using the surgical guide as reference. Many scientific studies validated this protocol and working strategy. The precision is very high with small deviation from the original digital design.

Guided implant surgery is a cutting-edge concept that is more and more employed by the dental community.
The help of machines and software helps the clinician to decrease potential of implant misplacement due to inexperience or complexity of the case.

It can be concluded that guided implant surgery is a mean of increasing working speed, comfort of the patient and precision on the execution of an implant surgery.

– By Lorenzo Mordini DDS, MS

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