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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.

Digital X-Rays.It's almost impossible to imagine the practice of dentistry without x-ray technology. Radiographs (x-ray pictures) allow dentists to diagnose and treat problems not yet visible to the naked eye, including early tooth decay, gum disease, abscesses and abnormal growths. There is no question that since x-rays first became available a century ago, this diagnostic tool has prevented untold suffering and saved countless teeth. Now, state-of-the-art digital x-rays have made the technology even safer and more beneficial.

Digital x-ray technology uses a small electronic sensor placed in the mouth to capture an image, which can be called up instantly on a computer screen. When digital x-rays first became available about 20 years ago, they immediately offered a host of advantages over traditional x-ray films, which require chemical processing. Most importantly, they cut the amount of radiation exposure to the dental patient by as much as 90%. While faster x-ray films have been developed over the years that require less exposure, making that difference less dramatic, a digital x-ray still offers the lowest radiation dose possible.

Advantages of Digital X-Rays

Besides minimizing radiation exposure, digital x-rays offer numerous advantages to dentists and patients alike. These include:

  • No chemical processing & no waiting. Because there is no film to process with digital x-rays, there is no waiting for pictures to develop — and no toxic chemicals to dispose of. Your dentist can immediately show you the pictures on a computer screen for easy viewing.
  • A clearer picture. It's possible to get more information from digital x-rays because they are sharper and can be enhanced in a number of ways. The contrast can be increased or decreased, and areas of concern can be magnified. It's even possible to compare them on-screen to your previous x-rays, making even the minutest changes to your tooth structure easier to detect.
  • Easy sharing and storage. Digital x-rays provide a better visual aide for you, the patient, to understand your diagnosis and treatment options. They can be e-mailed to different locations; they are also far less likely to be misplaced.

X-Rays and Your Safety

While digital technology has minimized the health risks of x-rays, it has not entirely eliminated it. X-rays are a type of radiation used to penetrate the tissues of the body to create an image. In doing so, there is always a slight possibility of causing changes at the cellular level that might lead to future disease. Of course, there are sources of radiation present in the daily environment — the sun, for example — that can also cause disease. It's important to note that the chance of this happening is thought to be cumulative and not based on a single exposure. Still, x-rays are not considered risk-free regardless of how technology reduces your exposure. That's why dentists will only use them when the benefit of obtaining better diagnostic information outweighs the procedure's small risk. This is particularly true of computed tomography or CT scans, which can raise the level of exposure, yet yield a tremendous amount of information per scan. No matter which technology is being used, each case is considered individually, and your safety is always paramount. If you have questions about why an x-ray is being recommended for you, please feel free to ask.

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