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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.

The dental implant is today's state-of-the-art tooth replacement method. It consists of a very small titanium post (the actual implant), which is attached to a lifelike dental crown. The crown is the only part of this tooth-replacement system that is visible in your mouth. The implant itself rests beneath your gum line in the bony socket that used to hold your missing tooth. Two, four or more implants can be used to support multiple crowns, or even an entire arch of upper or lower replacement teeth. Whether you are missing one tooth, several teeth or all your teeth, dental implants are preferred by doctors and patients alike. That's because dental implants are:

1. Most like natural teeth

Your natural teeth have roots that keep them securely anchored to your jawbone. In a similar way, implant teeth form a solid attachment with the bone in your jaw. This is possible because dental implants are made of titanium, a metal that has a unique ability to fuse to living bone. After an implant is inserted during a minor procedure done in the dental office, it will become solidly fused to your bone over a period of several months. Once that happens, your implant-supported replacement tooth (or teeth) will feel completely natural. It will also be visually indistinguishable from your natural teeth. Implant teeth allow you to eat, speak and smile with complete confidence because they will never slip or shift like removable dentures often do.

2. The longest-lasting tooth replacements

Because dental implants actually become part of your jawbone, they provide a permanent solution to tooth loss. Whereas other methods of tooth replacement, including removable dentures and bridgework, may need to be replaced or remade over time, properly cared-for dental implants should last a lifetime. That's what makes this choice of tooth replacement the best long-term value.

3. Able to prevent bone loss

You may not know it, but bone loss inevitably follows tooth loss. Bone is a living tissue that needs constant stimulation to rebuild itself and stay healthy. In the case of your jawbone, that stimulation comes from the teeth. When even one tooth is lost, the bone beneath it begins to resorb, or melt away. This can give your face a prematurely aged appearance and even leave your jaw more vulnerable to fractures if left untreated long enough (View Example). Dental implants halt this process by fusing to the jawbone and stabilizing it. No other tooth replacement method can offer this advantage.

4. Safe for adjacent natural teeth

Dental implants have no effect on the health of adjacent natural teeth; other tooth-replacement systems, however, can weaken adjacent teeth. With bridgework, for example, the natural teeth on either side of a gap left by a missing tooth must provide support for the dental bridge. This can stress those adjacent teeth and leave them more susceptible to decay. Likewise, a partial denture relies on adjacent natural teeth for support and may cause those teeth to loosen over time. Dental implants are stand-alone tooth replacements that don't rely on support from adjacent natural teeth.

5. Easy to care for

Caring for implant teeth is no different than caring for your natural teeth. You must brush them and floss them daily. But you'll never have to apply special creams and adhesives, or soak them in a glass overnight, as you would with dentures. They'll also never need a filling or a root canal, as the natural teeth supporting bridgework might. While implants can never decay, they can be compromised by gum disease. Good oral hygiene and regular visits to the dental office for professional cleanings and exams is the best way to prevent gum disease, and to ensure your dental implants last a lifetime, as they're designed to do.

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