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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.

Intra-Oral Camera.The intra-oral camera is a valuable tool dental professionals can use to help you understand your examination, diagnosis and treatment. This small, handheld video camera is about the same size as a dental mirror (or an oversized pen) and comes with a disposable plastic sheath for contamination prevention. It is used to take actual pictures of your teeth with up to 25 times magnification and project them onto a screen for your review. It can also be used to give you a video tour of your entire mouth so that you can see things such as plaque deposits, decay, worn teeth, and broken or missing fillings. Lastly, pertinent images can be printed for your patient file for future reference — or even for you to take home.

A Picture Is Worth a Thousand Words

This adage is proven true many times each day in offices equipped with an intra-oral camera. Prior to the development of this technology, some patients found it challenging to understand problems such as dental decay and periodontal disease. Now, it's possible to display, pause, and zoom in during a video examination of the problem area, so that you can see it for yourself — all in color and crystal clear.

Advantages of an Intra-Oral Camera

  • An intra-oral camera makes you more of an active partner in your dental treatment, enabling you to see what a dentist sees — an especially important benefit when additional treatments need to be discussed, or when treatment options must be explained — so that you can make informed decisions.
  • You may be more comfortable asking questions and better able to understand a treatment option or oral hygiene concern when you can actually see it.
  • Because it gives you the real-world picture of your dental hygiene, the intra-oral camera is ideally suited to show you techniques for improving your oral health and hygiene habits.
  • With its powerful magnification (much superior to the naked eye), it reveals the early stages of maladies such as gum disease and cavities.
  • The images can be captured and reexamined later, to show you changes in your oral health and hygiene or how a multi-phase treatment is progressing.
  • Furthermore, it can provide insurance companies with the proof they require to approve a needed treatment.