Membership Matters - November 2017 - 21

cross-sectional, panoramic, axial, and
three-dimensional views to confirm
they are within bone and in an optimal
position to support the desired restoration
(Figure 2). This process allows the
restoring dentist and the dentist placing
the implants to view the trial positions
of the implants and collaborate on any
adjustments to optimize their position.
With this process, intraoperative decisions
are avoided. Instead, decisions on implant
placement are collaborative and reflective.1
Once the collaborative planning
is complete, a stereolithographic
computer-generated surgical guide can
be ordered that will guide osteotomy
preparation and implant placement.
Teeth, soft tissue, bone or combinations
of tooth-tissue or tooth-bone can support
these surgical guides. The implant is then
surgically placed in the position as it was
planned on the computer (Figure 3). These
guides result in precise and accurate
placement of dental implants.2
In addition to collaborative planning
and precise implant placement, there are
additional advantages of computer-guided
implant dentistry. The surgical guides can
be used to place implant analogs in study
models, allowing fabrication of provisional
restorations in advance of surgical
implant placement. The patient can then,
provided there is appropriate primary
implant stability, receive an immediate
provisional restoration (Figure 4). In many
cases, an existing complete denture
can be converted to an immediate fixed
provisional prosthesis at the time of
surgery (Figures 5, 6). It is also possible, in
properly selected cases, to place implants
in a flapless approach (Figures 3, 4).
While this technology has been
available since 2002, it is only recently
gaining wider acceptance.3 One can
only speculate the reason for the lag in
adoption of computer-guided implant
dentistry. It requires mastering a new
software program and clinical procedures.
There is also some additional cost for the
patient. A CBCT will be needed, along
with the stereolithographic surgical guide/
template. The additional cost is typically
about 10 percent to 15 percent of the fees
www.oregondental.org

Figure 2. Virtual implant planning computer desktop views: 2A. Cross-sectional.
2B. Panoramic. 2C. Axial. 2D. Three-dimensional from the occlusal.
2E. Three-dimensional from the buccal.

Figure 3. Surgical implant placement using a computer-generated surgical
guide: 3A/B. Virtual plan. 3C. Stereolithographic computer generated surgical
guide. 3D-F. Osteotomy preparation with a flapless approach. 3G. Implant attached
to driver. 3H/I. Implant torqued into osteotomy. 3J. Implant site after placement.
3K. Post-operative periapical radiograph.
Figures 3B, 3F, 3G, 3J, and 3K previously published in Clin Adv Periodontics
2012; 2:263-273 and reproduced with permission from the American Academy
of Periodontology.
November 2017

21


http://www.oregondental.org

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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