Simplicity of Computer Guided Tooth Replacement with Implants

We now have the technology to replace missing teeth with computer guided dental implants.  That’s right, placing the implant virtually and then being able to transfer the placement position, angulation and depth accurate within 300 microns using an implant guide stent.  The success and quality of the implant is much more predictable now.

Day 8

4 Month

Final Restoration

The History

Surgeons and dentists used to take a 2 dimensional x-ray of your face to prepare for implant placement.  The dentist would make a stent which communicated the final position they wanted the implant crown to be.  The surgeon or dentist would estimate as best they could the third and blind dimension not seen on their image.  They would make an incision to help visualize their lost dimension and place the implant “by eye”.  Once they were done, they used sutures to close up the area.  The drawback to this technique:  1) They had to place the implant where they had quality bone to place it and they didn’t know until they “opened you up”, 2)  There are incisions and sutures and a bit more discomfort associated, 3) The bone quality was unpredictable. 4) The position and angulation was unpredictable. This didn’t always make for a successful outcome.

The esthetics and function of the implant crown is directly proportional to its position.  Basically, if the implant was placed dictated by where there was enough bone, the esthetics and function suffered.  There were and are some fantastic surgeons and dentists who were very good at this but even they ran in to surprises because of the missing dimension.

Dental X-rays Just Got Placed on Steroids

Then came the advent of 3 dimensional x-rays or Cone Beam Computer Tomography (CBCT or CT Scan for short).  This is an amazing upgrade from where we used to be.  Basically we have been working blindly our entire careers.  We can now see the “Third Dimension” before any incisions are made.  We had a computerized graphic representation of your face on our desktop.

We also have the ability to scan a model of your teeth and overlay it very accurately on to the CBCT (orange area).  We can virtually make the crown (blue area) and then position the implant according to the position of the crown.  This virtually guarantees an esthetic and functionally successful tooth replacement using an implant.  What is even better, there are no incision, flaps, or sutures.  Most people experience very little post-operative discomfort.  The procedure is done using local anesthetic and is completed in less than 45 minutes (actually about 20 minutes in an ideal situation).

The Drawbacks

This technology is proven but very new in terms of adoption.  .  There are not a lot of dental or surgical offices that have jumped on board.  As you might imagine, having a CT scanner in a dental office, along with a digital impression camera is quite expensive.  The tools for the computer guided implant placement are a steep investment so the commonality of a dentist having all of this is rare right now.  Every day we get closer to the goal of having this high quality of implant placement in every office.  The companies get more efficient in offering this wonderful technology to the masses.  For now, you have to do a bit of research to find a provider.

The Good Things

There are dentist and surgeons that have this technology. There are more dentists adopting it every day.   I suggest doing your research if you need a tooth replaced.  Ask your surgeon or dentist is they can see the 3 dimensional view of where the implant is being placed.

Every person going to a dentist should have a CBCT taken, even if there are no teeth to replace.  We can see problems much sooner with the 3D view than before.  Problems detected earlier are easier and less expensive to fix.  There are fewer unforseen future problems like undetected infections that blow up right before you are ready to board your plane to go on vacation.  Your quality of care goes up exponentially.