- Accurate implant placement can be performed in a template assisted, fully- or semi-guided procedure.
- Treatment plans can easily be shared with collaborators or referring clinicians.
- Regular calibration procedure ensure accurate imaging segmentation of the radiographic guide.
Today it is widely accepted that implant surgery benefits from computer-guided template-assisted surgery, particularly in complex situations. It is well understood that an accurate implant planning is critical to achieve an optimal prosthetic result.
In addition to the traditional fully guided approach, NobelClinician software offers the possibility to choose a “semi guided approach”, using only the initial guided pilot drill. The clinician is always freedom to decide between freehand, fully guided or pilot guided surgery during the course of planning, offering great flexibility in treatment management.
The surgical guide for use in implant treatment is fabricated based on the patient’s anatomy and the planned implant positions. Tridimensional orientation and depth of the first drill are crucial steps during the implant site preparation. The NobelGuide pilot drill template helps to overcome this challenge by setting the preplanned drilling trajectory and depth while still enabling clinicians to finish the surgery using freehand techniques. This approach is very helpful in single implants due to the reduced diameter of the sleeve that allows it to be positioned between two adjacent teeth. An optional wax-up can be added into the planning process to help the clinician plan the best possible implant position based on the prosthetic requirements.
Studies evaluating the cost efficiency and treatment time of different treatment work flows are scarce. However, clinicians should inform patients that computer-assisted template-based surgery implies an increased planning time and slightly additional costs. However, the additional cost should be analyzed in terms of cost-effectiveness and consider the reduction of surgery time and post-operative pain and swelling, as well as, the possible increased accuracy. In fact, digital workflow has been shown to be more efficient than the conventional pathway, reducing the overall treatment time and costs. Avoidance of critical anatomic structures, the aesthetic and functional advantages of prosthodontic-driven implant positioning must also be considered.
Figure 1 Figure 2 Figure 3
Figures 1-3: Implant placement using semi guided protocol. Pilot guided drill (Figure 1); flap elevation (Figure 2); peri-apical radiographs showing one-stage approach and trascrestal sinus floor elevation (Figure 3).