Virtual planning for dental implant placement using guided surgery

Abstract

1. Introduction Technical and scientific advances in diagnostic and therapeutic methods in the biomedical field have substantially increased the predictability and longevity of the outcomes of restorative surgical procedures. In contemporary oral implantology, bioprototyping techniques based on computer-aided design and computer-aided manufacturing (CAD/CAM) technology have proven to be valuable aids in diagnosis, treatment planning, and surgical intervention. Among other aspects, use of these technologies improves preoperative planning, makes it easier for patients to understand proposed procedures, increases the predictability of treatment, and may reduce surgical morbidity. The preliminary stages that precede dental implant surgery are as important as the actual operative intervention itself, or even more so. Inadequate placement of implants may injure important anatomical structures or lead to aesthetic or functional compromise of the prosthetic stage of oral rehabilitation. Implant planning and placement can be based solely on computed tomography data and surgical guides fashioned after diagnostic models. However, direct three-dimensional visualization of the surgical site and real-model simulation of the intended surgical procedure can play a significant role in obtaining outcomes that are more consistent with the original treatment plan. Biomedical prototypes, or biomodels, provide faithful reproductions of the patient’s bone condition, thus enabling this type of assessment. Likewise, the surgery itself can be made safer and less invasive with use of individualized surgical guides for implant placement. The development of software programs for implant placement planning and the integration of these software packages with rapid prototyping methods have made fabrication of such guides possible. The process of obtaining and reformatting computed tomography (CT) data, planning implant placement over a virtual model, fabricating a surgical guide with prototyping methods, and using this guide or template during dental implant surgery with specifically designed systems may be referred to as guided implant surgery.