Patients are increasingly aware of how implant dentistry can help them achieve a beautiful, fully functional, and healthy smile, even when they are completely edentulous. Dental technology has evolved to meet the demand for better esthetics and more predictable results. Dentists are now able to utilize the most up-to-date 3D implant solutions, which improve treatment outcomes and increase patient satisfaction. Embracing the digital workflow and restorative-driven implant treatment can be advantageous for both clinician and patient.
Clinicians can now precisely plan surgery and implant placement, resulting in a reduced number of appointments and quicker and smoother treatment processes. Digitally planning treatment can increase your confidence in being able to provide the patient with the most clinically advanced treatment. Often patients receive a complete implant treatment during a single clinical procedure and will leave with an expertly fabricated temporary or even permanent restoration in place.
Traditionally, the clinician would place the implant in the available bone before deciding how best to design the restoration. Reversing this process allows the clinician to decide on the design of the restoration at the start of the treatment process, helping to eliminate unwanted surprises that develop if an implant has been incorrectly angled or located.
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A restorative-driven implant treatment begins with a patient’s cone-beam CT scan. The scan is used to clearly identify all anatomical structures and to evaluate bone density. The next stage is to create a digital model, which is accomplished either by scanning a traditional impression or by using an intraoral scanner to create a digital impression. Interactive treatment software enables the information from the digital impression and from the cone beam CT scan to be merged. At this stage, you will begin planning the implant and the abutment, usually liaising closely with your dental laboratory. The treatment plan will consider the fit and function of the final restoration, and the software will allow implant sites to be closely evaluated from multiple views. For example, the software makes it possible to digitally remove bone or to make the bone appear transparent. These software functions make it far easier to clearly visualize the precise placement of implants, abutments, and virtual restorations and their proximity to natural teeth and other vital structures. A virtual crown can guide the placement of a virtual dental implant, allowing the implant to be thoroughly assessed for esthetics and function. This approach makes it far easier to properly assess the design of the restoration and to determine the implant diameter and length. The next stage is to import this data into software that will be used to design and fabricate the surgical guide.
The surgical guide provides the physical link between digitally planned implant treatment and the surgical procedure. It is vital to recognize that a surgical guide reflects the efficacy of a treatment plan and doesn’t guarantee a successful outcome. Precision is only possible after carefully evaluating the implant site, assessing the implant dimensions and components required to complete the case, and deciding on the best type of abutment. In conjunction with good planning and judgment, a surgical guide facilitates the likelihood of achieving a good result and acts as a safety measure. The surgical guide eliminates the guesswork required when placing an implant freehand. Every possible permutation during the placement of dental implants will have already been considered and evaluated before selecting the best location and angulation. A digitally made surgical guide is extremely accurate, which improves the patient’s overall comfort during surgery.
When deciding to have dental implant treatment, patients want to feel confident in their chosen clinician and treatment plan. Many are also interested in the actual treatment process and welcome the opportunity to learn more about how dental implants can facilitate better dental health. A good treatment plan that includes highly defined stages and 3D images can increase a patient’s confidence and likelihood to accept the proposed treatment plan. It can be very reassuring for them to know that their treatment has been digitally planned and to learn how this plan is transferred to a surgical guide. Showing evidence of the treatment plan’s accurate replication during surgery calms nervous or anxious patients and assures them that their treatment will be as smooth and as comfortable as possible while still retaining a high degree of accuracy.
Computer-guided treatment creates digital files to share with the dental implant team and with the dental lab. Clinicians create a digital impression that is immediately viewable and which can be modified or rescanned if required, all while the patient is still in the chair. Digital files allow a dental lab to quickly evaluate a case, which is useful when determining implant costs. Digital data also helps to create a faster workflow, expediting the treatment process. Digital impressions are quicker to receive, and, unless specified by the clinician, there may be no need to create a physical model or wax-up. Files from the digital impression and from the cone beam CT scan are merged using implant planning software, allowing the clinician to create and present a treatment plan more quickly. As soon as the patient accepts the treatment plan, surgery can be scheduled, since digitally transferring files eliminates shipping delays. The use of CAD/CAM restorations and 3D imaging technology increases the possibility of immediately loading the restoration, saving time post-operatively.
Achieving good clinical outcomes without using restorative-driven planning is possible; however, restorative-driven planning delivers a reliable outcome more quickly, using more cost-effective methods. Treatment is efficiently planned, resulting in fewer appointments, and a streamlined digital workflow facilitates predictability and surgical accuracy. Perhaps, most importantly, patient satisfaction can be higher, because they receive fully functional teeth that are comfortable and look good.
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