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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.

Your first orthodontic appointment.Your first appointment is an exciting time! It's a chance for you to learn about the treatments and services that can help give you the best smile possible. It all starts with the initial consultation.

You should plan to spend at least an hour at the first visit. That's to ensure that no one has to rush, and that you get plenty of time to ask any questions you may have. You will meet one of the receptionists or patient coordinators, who will take some information from you and bring you through the office. Then it's time for some diagnostic work and an exam.

Making a Plan

A big part of the first visit is to determine what treatment is necessary to correct any problems found — and whether to begin now, or wait until a later time. The procedure starts by taking a set of regular photographs of the teeth in their present state. Next, a series of radiographic (X-ray) images will be taken. These show what's going on underneath the gums: the position and growth of bones and joints, and the teeth that are still below the gum line.

In some cases, an impression (mold) of the teeth is also taken to create an exact replica of the bite. This helps reveal exactly what the problem is and how best to treat it. The impression is made by biting down on some soft putty-like material for a few moments; then it's removed.

After that, it's time for the exam. Besides looking in the mouth, we you may be asked questions, such as whether the jaws make noise when the mouth is opening or closing, or if there are any problems chewing or swallowing. Taken together, this information will yield a proper diagnosis so a treatment plan can be finalized at the first visit.

Discussing Your Treatment Options

Following the exam, you may be told that things are just fine — or, treatment may be recommended. It might begin right away or at a later time, depending on the developmental stage of the teeth and jaws. Many times, you'll be advised to return for periodic checkups until it's time to start.

Whether you're starting now or later, the first visit is the best time to ask questions about the process. Topics to discuss include treatment choices, what to expect at the different stages of the process, and any of the following:

  • Can orthodontic treatment benefit me (or my child)?
  • What general procedures will be used to correct the problem?
  • Are any options available (or recommended) for my treatment?
  • Should I get treatment now, or is it better to wait?
  • Will tooth extraction be necessary?
  • How much does treatment cost? Are payment plans available?
  • How long do you expect treatment should take?

When you leave the office, you should have a better understanding of how you can get the best possible smile.

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