Dental implants are more versatile and predictable than ever before. This is due not only to the advancements and variety of the implants themselves, but also in how they are planned for prior to treatment.
In the not too distant past, dental implants were placed where there was the most amount of bone, irrespective of the tooth or teeth that were to be supported by it. Using only a small check-up film or a 2D larger panoramic film, there was a lot of guesswork to position the implants properly without invading sensitive structures such as nerves and sinuses.
In addition, almost always, the tissue needed to be cut and peeled back to visually examine the bone that the implant was supposed to go into.
If only there was a way to "see" under the tissue and visualize the best position to safely place the implant.
Well, in fact, there is.
It is commonly referred to as "3D Cone-beam." This is a special kind of X-ray that allows an accurate actual size, three-dimensional rendering of a patient's jaws.
Using this technology, the nerve of the lower jaw can be mapped clearly as a structure to avoid. On the upper jaw, the sinuses can be seen in all dimensions - again, as an area to avoid.
Using a downloaded catalog of every implant imaginable, the dentist can virtually place the implants in the correct position within the bone.
Using additional aides such as radiopaque teeth in the spaces where implants are desired, it allows the operator the ability to place the implant in a favorable position for the final restoration of the teeth. This is especially useful in the upper anterior arch, where cosmetic appeal is of paramount concern.
From these pictures, a lab can construct a surgical guide for the dentist so that all the planning will be guaranteed to be part of the final outcome.
This is possible whether replacing individual teeth, entire arches of fixed teeth or implant retained dentures.
The ultimate in progressive technology utilizes Cerec, the single-crown-at-one-visit wonder.
In planning, a crown can be designed in the space, and this software overlays with the 3D software so that a virtual implant can be placed directly under it. This is called crown-down design.
Remember the past days where implants were placed wherever there was bone? This sometimes made the final restoration difficult if the implant was out of position or at the improper angle.
In the final restoration phase it is now possible to restore the implant in a day using Cerec. The crown was already designed and positioned in the planning phase. Now it is a simple matter to use this design to fabricate an implant crown.
Even Ben Franklin knew that "failure to plan was a plan to fail." No need to take that risk with today's fabulous technology.
James G. Jenkins, D.M.D. is the owner of Bluffton Dental Care in Bluffton.