Membership Matters - November 2017 - 20

Collaborative Care and Guided
Implant Surgery
SURGERY

By Joseph V. Califano, DDS, PhD

HISTORICALLY, ENDOSSEOUS
DENTAL IMPLANTS WERE PLACED
in the available bone without
consideration for the restoration
they might support. While this
occasionally resulted in a satisfactory
clinical outcome, more often, it left
the restorative dentist with a dental
implant that could not be restored
with a functional and esthetic
prosthesis. It is now universally
accepted that the surgical placement
of dental implants should be
prosthetically driven. Planning for the
optimal three-dimensional position
of a dental implant begins with a

diagnostic wax-up and design of the
final prosthesis. Therefore, in cases
where the restoring dentist is not also
performing the surgical placement,
this is a collaborative process.
When a surgical approach utilizing
conventional surgical guides is
employed, the restoring dentist
prepares a guide derived from
the diagnostic wax-up that brings
prosthetic information to the surgery
(Figure 1). The dentist surgically
placing the implant makes an
intraoperative decision on the optimal
position of the implant. This decision
is unilateral, as the restoring dentist

is typically not present at the time of
implant surgery. It is also reactive, as
the surgeon can only fully appreciate
the available bone volume and its
relationship to the desired prosthesis
after the bone is exposed during
the surgery.
With computer-guided implant
dentistry, a scan of the diagnostic
wax-up is merged with a cone beam
computed tomography (CBCT)
image using implant planning
software. The result is an interactive
computer file that allows implants to
be placed virtually on the computer.
The implants can be viewed in

Figure 1. Surgical placement and restoration using a conventional surgical guide: 1A. Preop. 1B. Flaps reflected. 1C. Conventional
surgical guide. 1D. Osteotomies complete and surgical guide in place with paralleling pins. 1E. Flap closure with healing abutments.
1F. Final healing with restorative abutments in place. 1G. Final restorations buccal. 1H. Final restorations lingual.
20

Membership Matters

Oregon Dental Association



Table of Contents for the Digital Edition of Membership Matters - November 2017

Guest Editorial
New Members, Dental Community, Board of Trustees
Events and Education
Molar Movement
Insider Results
ODA Member Benefit of the Month
Compliance Corner
Dopac and the 2018 Election Season
Through the Loupes
Collaborative Care and Guided Implant Surgery
Antimicrobial Treatment for Advanced Periodontal Disease
Society Updates
Dental Foundation of Oregon
Index of Advertisers
Membership Matters - November 2017 - Intro
Membership Matters - November 2017 - cover1
Membership Matters - November 2017 - cover2
Membership Matters - November 2017 - 3
Membership Matters - November 2017 - Guest Editorial
Membership Matters - November 2017 - 5
Membership Matters - November 2017 - New Members, Dental Community, Board of Trustees
Membership Matters - November 2017 - 7
Membership Matters - November 2017 - 8
Membership Matters - November 2017 - Events and Education
Membership Matters - November 2017 - 10
Membership Matters - November 2017 - Molar Movement
Membership Matters - November 2017 - 12
Membership Matters - November 2017 - Insider Results
Membership Matters - November 2017 - 14
Membership Matters - November 2017 - ODA Member Benefit of the Month
Membership Matters - November 2017 - Compliance Corner
Membership Matters - November 2017 - Dopac and the 2018 Election Season
Membership Matters - November 2017 - Through the Loupes
Membership Matters - November 2017 - 19
Membership Matters - November 2017 - Collaborative Care and Guided Implant Surgery
Membership Matters - November 2017 - 21
Membership Matters - November 2017 - 22
Membership Matters - November 2017 - 23
Membership Matters - November 2017 - Antimicrobial Treatment for Advanced Periodontal Disease
Membership Matters - November 2017 - 25
Membership Matters - November 2017 - 26
Membership Matters - November 2017 - 27
Membership Matters - November 2017 - Society Updates
Membership Matters - November 2017 - 29
Membership Matters - November 2017 - 30
Membership Matters - November 2017 - 31
Membership Matters - November 2017 - Dental Foundation of Oregon
Membership Matters - November 2017 - 33
Membership Matters - November 2017 - Index of Advertisers
Membership Matters - November 2017 - cover3
Membership Matters - November 2017 - cover4
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