STEP BY STEP – Implant Studio
Avinent Implant System
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Planning 12 implants with Implant Studio (Real Case)
The use of new technologies for the planning of complex cases is a reality in day-to-day practice for a great number of clinics that work on digital dentistry. One of these tools is the famous 3Shape software, Implant Studio. A tool that bases its working on the union of two files with patient information. On the one hand the soft tissue and pieces of the individual and on the other hand the available bone (TAC + dicom).
This technique allows reaching implant surgery with an exact planning of how are we going to place the implant in reference to the prosthesis that we have designed along with the laboratory and the doctor. By means of guided surgery and a series of tools such as surgical splints and drill ceilings, we are going to put the guided implant in direction as well as in depth.
In order to success a correct planning we have to follow a few steps with the Implant Studio software that we describe in detail below. We have chosen a real case of 12 implants (6 upper + 6 lower) that are accomplished by means of guided surgery.
1. Create the order
The first step is to mark all the teeth where we are going to put the implants. We choose the adjacent teeth as well and we mark everything like a bridge. For the locations where we will place the implants, we will choose Planning of implants and Guided surgery options. Then we will load the files. In this case we have the upper and lower scans of the patient as well as the corresponding TAC.
2. Definition of the interest area or relevant information
With a few rectangles of all three views we will select the area that we want to visualize.
The first step of the planning consists in trimming off the cuts of TAC. This is used to accelerate the programme and to avoid that the software shows unnecessary elements, as the spinal column for instance.
3. Best Fit
The lining up or “Best Fit” consists in marking three points of the scan and the same 3D points of TAC. The software carries out an automatic interpretation of the points and joins them together, creating therefore a line up between both files or both marked information. The quality of the lining up is checked with a colour map. As we can see on the image, the visible pieces are coinciding perfectly.
4. Panoramic curve
The following step consists in drawing a panoramic curve, which will define the future views used for the planning. First we will put the occlusal plane or its position. Then, in the middle-left view, another panoramic curve will be drawn to define the two cuts that we have on the right.
5. Definition of the mandibular nerve
To do so, we are looking for the exit of the channel and from then we start following the route of the nerve.
The position of the nerve is defined from its density, which appears as a black point on the cuts as it is below the bone.
6. Virtual waxes
In order to facilitate the planning, virtual waxes are made. These virtual teeth will help us to place the implants as we will be able to see approximately how the implants will be located according to the future prosthesis.
7. Implants positioning
The following illustrations show the planning part. As we can see, in the central part we have a general 3D view. On the lower part of the screen we have the panoramic view and two cut planes. We place the implants above these planes. Thanks to different tools, it is possible to visualize or hide elements (TAC, scans, etc.) and see where exactly we have planned the implant. There are measurement tools as well that help us to secure the correct positioning. What is more, the programme incorporates a series of limits that avoid collisions between implants and mandibular nerve.
8. Design of the surgical splint
First of all, the limits of the splint are marked and the software creates us a design immediately. Right after we add the support material in the areas where it is needed. We also let a few windows so that the doctor can irrigate the surgery area during the process. Creating a cross cut, we can see the existing adjustment between the splint and the teeth or the soft tissues. As last step, an indicative reference is added and sent afterwards to the lab for the design of the (temporary o final) prosthesis and at the centre of milling for the printing of the surgical splint. Before the surgery the doctor will analyse the report that the same software creates automatically, depending on the implants system that was chosen. This report details all the tools that the doctor has to use during the protocol of implants insertion. (drills, rings, spoons…)
Collaborators: Clínica Dental Mataró
TagsAdvanced esthetics, Materials, Dentistry 4.0, Dental System, Guided surgery, 3D printing, 3Shape TRIOS, Dental prosthetics, Cad-cam, Implants