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Technology can be a wonderful thing and it’s even contributing to the surgical placement of dental implants! Imagine if we could place your implants without the need to incise the gum with a scalpel and then having to suture (‘stitches’) it back together after implant placement.
Computer-guided surgery allows us to do just that! It is based on guided keyhole surgery that is minimally invasive, allows for more rapid healing and results in less potential of post-operative complications such as bleeding, pain and swelling. It is even possible to combine this treatment with immediate function, for instance by pre-production of a temporary acrylic bridge prior to surgery and fitting it immediately to the implants on the day of surgery to provide you with ‘same-day’ teeth. Often our patients return to work or to normal social activity by the next day!
So how does this all happen? Firstly a diagnostic guide (so-called radiographic guide) needs to be made for you. This replaces the missing teeth and provides you with some insight into what the final implant-supported prosthetic teeth will look like. You need to wear this when you have a special radiograph taken. This is called a CT scan and must be taken at a radiology clinic where they are experts with the procedure and technique. We will provide you with an appropriate referral and a double-scan will be completed.
First a scan is taken with you wearing the radiological guide as well as an index. The index is a silicone rubber bite wafer (we fabricate this for you) which is worn between the radiological guide and your apposing teeth. This stabilises the guide so that it does not move during the scan. Then a second separate scan is taken of your radiological guide by itself. The radiology clinic then delivers us a written report as well as films and most importantly a computer CD containing your radiographic data.
This data is in a format that is compatible with our ‘state of the art’ software which allows Dr Herbert to carry out the planning of your case. Essentially, the computer will generate a 3D image of the jaw over which can be superimposed a 3D image of your radiological guide and Dr Herbert will place the appropriately sized implants ‘virtually’ on the computer in the correct position, angulation and depth as it relates to both jaw anatomy and tooth set-up.
Once he is happy with the planning and through the magic of the internet, the data is sent electronically (like e-mail) overseas (usually Japan, Sweden or Germany) and via a patented high tech Cad-Cam process this electronic data is then transformed into a very real acrylic surgical guide.
The guide is returned to us by post and then tried in your mouth prior to surgery. This guide will allow Dr Herbert to place the implants ‘blind’ knowing they will be in exactly the right place. Please note that the CT scan for this procedure is designed with special protocols which minimise radiation dose compared with CT scans for many other medical procedures and both the CT scan and manufactured surgical guide are not claimable through private health funds or Medicare.
However the added expense is more than compensated for many of our patients by the faster recovery time and less time off work. Computer-guided surgery is useful for multiple implant cases and is not necessary for placement of a single implant. Furthermore, not all patients are suitable for computer guided surgery. There still needs to be adequate bone volume and architecture to place the implants. A CT scan is necessary to determine if you are suitable for guided surgery. For those patients with failing natural teeth which need to be extracted, Dr Herbert can prepare the mouth for guided surgery at the time the teeth are removed, making later implant placement a safe, predictable and comfortable procedure.
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