The computer guided surgery has been developed recently, and was accepted as a mode of implant treatment in the maxilla and mandible, with or without immediate loading.
The computer-assisted design of the treatment and the therapeutic plan implant-prosthesis allows operators to reduce the risks arising from possible changes in anatomical or pathological conditions of the patient, to reduce the invasiveness of and optimize the positioning of the installations in function of a rehabilitation prosthetic led to functional recovery, respecting the canons of aesthetics, phonetics, vertical dimension and correct occlusal relationship.
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First, the software – available for different operating systems – are able to read and revise DICOM files of preoperative CT, allowing the clinician to assess the state of bone, soft tissue, anatomic structures and relationships with the noble dentule areas.
The next step that follows is guided surgery proper, ie the positioning of the implanti in chosen sites, carried out by the use of a mask individualized. Let’s see how to achieve it.
Once it established that the degree of opening of the mouth and the space between the elements residues are sufficient to insert the same mask, there is provided a jig, the laboratory stage equivalent to a diagnostic wax. The patient then is subjected to a CT scan template, positioned with a silicone chewing.
The scout view, from which images are acquired, will have to be always the same, to avoid that the diameters are distorted; it is recommended therefore, before the law examination, always ensure that the radiologist has set the reference planes correct (Frankfurt for the maxilla, lower edge of the jaw) and, if not, correct the skew. At that point it will be possible to plan in detail the positioning of the implant fixture; They are available free software, where you can choose any system on the market, and closed, that is provided by the implant homes for their products.
Most of these programs can transfer the DICOM file in STL, thus allowing the optical scanning of the CAD model and the mask and the realization of real CAM model, ie a model containing the holes for the plants chosen.
At this point, the drilling template will be produced: all guided surgery software allow you to program a flapless surgery, conducted with mucotomia punch at the selected sites; For this reason, the implant computer guidataviene often identified with the flapless, but it is not so, as some programs evaluate the thickness of soft tissue, allowing the creation of a flap, if necessary.
