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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.

Itero.For years, whenever you needed a dental crown (cap), your dentist had to make molds of your teeth which required taking an impression of your teeth. A tray filled with a goopy, putty-like material was used so that a three-dimensional model of the prepared tooth could be created. Using this mold, a dental lab could custom-craft the new crown.

However, as we journey further into the technology-driven 21st century, this traditional methodology is being replaced with virtual models — made using small, handheld “wands” that employ a digital camera and some reflective dust.

Here's how it works

The initial phase of restoration, preparing the tooth surface, remains virtually the same. First, any dental decay must be removed, and the remaining tooth must be shaped so that a crown or filling can be fitted properly. This will allow the tooth to be restored to its original shape, look, and function. Next, the area is lightly dusted with a reflective material (not a goopy impression material) so that multiple images of your tooth's surface can be recorded with a small scanning wand. Later, the computer component is connected to the scanning wand and these separate images are combined into a computer-generated 3D image.

Itero Scanning Teeth.This remarkable tool uses blue wavelength light to precisely capture the unique nooks and crannies of your tooth's surface and make a highly accurate 3D digital model. It makes it possible to instantaneously examine your tooth, and your bite. It's possible to identify any additional prep work required for new crowns, veneers and fillings right then and there; to implement any needed changes; and to rescan the tooth to create a new series of images and 3D model.

Once the image capture and prep work are satisfactory, your images are sent on to the lab for fabrication. This technique makes it possible to create a crown or a filling that can often be completed during a single office visit.

How this technology benefits you

  • Finally, you can say goodbye to the goop, gagging, discomfort, and anxiety you've experienced in the past with traditional dental impression materials!
  • It enables the immediate assessment of whether or not your tooth has been properly prepared for restoration.
  • This technology is ideal for fabricating restorations such as new crowns, veneers and fillings for teeth — often possible in one office visit.
  • It takes less time than traditional dental impressions.