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Digitally Guided Implant Placement

The use of dental implants to replace missing teeth has been around for a long time and is the spearhead of modern dentistry. The success of the treatment depends on a combination of understanding the anatomic structure of the jaw, the ability to insert the implants and place the desired final restoration. It is not enough just to insert the implant into the jaw. It is also important to know whether it may serve the desired restoration (information such as the implant’s length, width, location and insertion angle).

Digital tooth implantation – how has it developed?

Previously, dentists relied on a clinical examination of the patient and estimation using two dimensional x-rays, such as panoramic x-rays, to plan the course of the work. The success of the treatment depended primarily on the dentist’s capabilities and the human factor was the most pivotal one. Over the years, there have also been changes in imaging equipment, and CT imaging became available to the implanting dentist. CT imaging allows the dentist to scan the patient’s jaw throughout, like “onion layers”, thus receiving a three-dimensional image. The thickness of each layer or slice can be altered, and this way we can digitally reconstruct and “see” the entire anatomic structure of the jaw bone and anything requiring caution (for example, the nerve canal that passes in the mandible or the sinuses in the maxilla, the bone thickness, how dense the bone is, etc.). This information is extremely important and has greatly advanced dental implant placement, but the practical planning and execution are still dependent on the dentist and his skill only.

In recent years, there has been a significant quantum leap in the dental implant placement – the introduction of digital implant surgery. This refers to the option of combining advanced imaging modalities with a computer system that will allow not only planning of the case but also a smoother and safer implant placement.

How is the digital tooth implant surgery process done?

After a clinical examination, gathering of initial data and a decision on the desired restoration shape, an impression or an intraoral scan of the patient’s jaws is taken. The dental laboratory designs and positions the teeth in the desired restorative positions. This plastic model is tested in the patient’s mouth, and after we have seen that it is a feasible option, the patient will be sent to a CT scan. The advantage this time is that the patient will undergo a CT scan with the desired model of the final restoration inside his mouth. The material that the model is made of will effectively allow us to see the intended teeth crowns, relative to the anatomical structure of the jaws. This information is transferred to a specialized computer program that takes all CT image layers and builds a three-dimensional model of the jaw. At this stage the dentist may use the software to plan exactly where to position the implants, the depth at which they are to be inserted and their angle, to match the chosen restoration shape. At the end of the planning process, a “surgical template” is prepared in the laboratory – effectively, this a plastic plate with holes guiding the exact location and angle of the implants. The only thing left for the dentist to do is to place the template in the mouth, drill through the holes and insert the implants.

The advantages of digital dental implant surgery

    1. More precise planning ensures better results.
    2. In many cases, the process of inserting the implants is done without a preliminary periodontal surgery procedure, i.e. without opening the gums. The level of pain is reduced, and the recovery process is quicker.
    3. Fewer human errors.

    A significant disadvantage of the digital dental implant surgery method is its high cost that is added to the cost of the treatment, because multiple preparations and lengthy planning must be used, which require precious time and equipment.
    It is worth using this technique to increase the odds of success in complex cases or when there is a significant bone deficiency in the jaw, in a case of a precise location or an area with high chances of damage.