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Imagine this: An implant surgeon is performing a thorough examination of your mouth. The surgeon rotates your jaw from side to side and up and down, looking for the optimal sites in which to place dental implants — and the proper size, shape and orientation for the implants to have. He or she may test several alternatives, considering the underlying anatomical structures, and the bone density and quality that the examination reveals. Finally, a surgical plan is developed: This includes a set of precise specifications for implant position, size and depth, and a template for creating a perfectly fitting set of replacement teeth. But no invasive procedures of any type have been performed so far. In fact, you aren't even present.

Welcome to the world of computer-guided dental implant surgery. What we have described is one step in the process that allows you to receive a set of replacement teeth with the minimum amount of surgery (and time spent in the dental chair), and the maximum level of preplanning foresight. It can result in faster overall treatment time, less discomfort, and an outcome that pleases everyone. Let's look a little more closely at the entire process of computer-guided implant surgery — a procedure at the forefront of dental implant technology.

The First Phase: Making A Virtual Model

It all begins with a complete examination and modeling of your existing teeth, gum and jaw structures. In many cases, a physical impression (replica) of the jaws is made, which will aid in planning the location of the new teeth. But the modeling doesn't stop there: A high-tech, three-dimensional CT (computed tomography) scan is also performed. This allows us to examine the structures (including bone, nerve tissue and sinus cavities) which lieinside the jaw. It is often accomplished using “cone-beam” CT technology, in which the scanning device quickly captures a complete digital image of internal structures as it rotates around your head.

The next step of the process relies on powerful computers and sophisticated software to take the raw CT scan data and translate it into a 3-D model of the jaw. This virtual model can be manipulated on a computer screen — rotated, measured, even “operated” on — so that we can visualize the placement of dental implants and determine their optimum position with a high degree of accuracy. Using this technology, it's now possible for us to evaluate anatomical structures virtually — structures it once would have taken surgery to reveal — and to plan out the implant procedure accordingly.

The 3-D model we have developed is then used for two purposes: to create a precise guide for the implant surgery, and to allow the dental laboratory to pre-manufacture a set of replacement teeth that will fit precisely in the jaw. An advanced set of CAD/CAM (computer aided design/manufacture) processes is used to generate the physical objects — in this case, the surgical guide and the prosthetic teeth. Depending on your individual situation, the new teeth may be attached the same day as implant surgery, or after a healing period of 6 to 12 weeks. In either case, our precision modeling ensures that they will fit perfectly with the implants and the jaw.

Implant Surgery: Following the Plan

The implant surgery itself is typically performed under local anesthesia, and often requires no sutures (stitches). In the surgical procedure, the template we have produced (which resembles a nightguard or athletic mouthguard) is securely (but temporarily) fixed in position on the jaw. The openings in this template form precise guides for the placement of the implants — accurate in terms of position, width and depth. In fact, the implants fit so perfectly into these prepared sites that we can have new teeth placed the same day as implant surgery.

Since so many of the details have been accomplished in the planning stages, computer-guided implant surgery is typically uneventful for the patient. It can result in shorter time in the chair, less discomfort during recovery — and a highly pleasing result. It has even been called the most significant innovation in implant technology since osseointegration — the fundamental process by which a dental implant becomes fused with the bone.

Before and After Smile Makeover.Smiling with confidence makes you feel great. A beautiful smile is also an important social and professional asset. Yet there are many people who avoid showing their teeth in public or in photographs because they don't like what they see. If that describes you, then why not start the process of getting the smile you've always wanted with a smile makeover?

A smile makeover goes beyond simply responding to dental problems as they arise. It's a comprehensive smile-rejuvenation plan that's uniquely suited to your own facial features and aesthetic preferences. The results can be quite dramatic — both in terms of how your will look and how you will feel. These are the major steps involved:

Take a look. The makeover process is all about giving you the smile of your dreams. So take a good look at your smile and note what you like and don't like about it. Some questions you can ask yourself are:

  • Are your teeth as white as you'd like them to be?
  • Are any teeth chipped, cracked or worn?
  • Does your smile have a gummy appearance?
  • Do your teeth seem too large or small?
  • Do you like the alignment and spacing of your teeth
  • Are you self-conscious about crookedness or gaps?

Remember, beauty is in the eye of the beholder… and that's you! Some people want their smile to look “perfect” — and to them, that means completely straight, uniformly white teeth. Others like a slightly more natural look, and are not displeased by slight gaps or shade variations. There are lots of decisions to make, but don't worry — dentists are skilled at helping you sort it all out!

Cosmetic dentistry video

Share your thoughts. Communication is an extremely important part of the smile makeover process. At the first makeover consultation, it helps if you describe what you would like to change in as much detail as possible. Bring along pictures of smiles you like, or of how your own smile used to look. Your makeover dentist will have some thoughts to share with you as well because dentists are trained to look at smiles in terms of facial balance. In other words, a dentist will look not only at how the elements of a smile (teeth, lips and gums) relate to each other, but also how they blend in with the face as a whole.

Make a plan. An important part of planning a smile makeover is a comprehensive dental exam. Cosmetic dentistry offers an amazing array of lifelike tooth restorations and treatments; but first, any conditions in your mouth that may jeopardize a good result must be taken care of. If your teeth are discolored, for example, the reason must be determined. You may have an underlying dental disease that needs to be treated before whitening your teeth; otherwise, the whitening may not last. Likewise, if you often drink red wine or other beverages that stain, you might do better with porcelain veneers than bleaching treatments.

Try it out. A smile makeover is an investment that is meant to last. That's why many of the procedures performed are irreversible. So if you are contemplating some changes, it's a great idea to try them out before you fully commit to them. There are many ways to preview the results: computer imaging, 3-D models, and even placing temporary restorations on your teeth so you can see what the final results will look and feel like in your own mouth. This also allows a fine-tuning of the makeover plan.

A “trial smile” is a great way to eliminate unknowns in the makeover process. But when it's all done, there's still one thing you may not be prepared for: how great it feels to flash your new smile to the world!

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