Co Localize Implant Placement with Desired Restorative Outcome

A:

Great question! As you know, dental implant therapy should always be restoratively driven. Therefore, it is the restorative dentist that is responsible for the desired prosthesis. The desired restoration should allow for co-collaboration of the dental implant placement. The best way to communicate this desired implant placement to the surgeon is with the use of a surgical template. While there are many ways to fabricate a surgical template they should follow several basic criteria.

-  Co localize implant placement with desired restorative outcome

-  Stable and retentive on teeth

-  Able to be sterilized

-  Techniques for partially

Follow these simple steps

1. Diagnostic waxing of desired restoration (Figure)

2. Duplicate cast of desired restoration

3. Use a thermoplastic matrix on the cast of the desired restoration. Material should be 2mm-3mm in thickness to provide ridged support (Figure)

4. The matrix should be trimmed for the cast at the height of contour of the retentive teeth and maintain the entire outline for the desired restoration (figure) Recommended bur for trimming this thick material : Brassler

5. Lubricate a cast that has the missing tooth/ teeth fill the missing tooth portion of the template with clear ortho ______resin. Place the template onto the cast and alow the material to set (Figure ) working the template on and off the cast as it sets prevents it from locking on.

6. Upon collaboration with the surgeon place a hole in the desired position of the implant template taking into account the clinical radiograph adjacent teeth and anatomic structures. Figure) do not compromise the implant position due to lack of bone. There are many predictable grafting techniques to improve ridge width and height you may want to reduce the clinical height of the template or create an access grave to make it easier for the surgeon to place the guide drill into the template (figure)

This technique does not take into account the exact position under lying bone and anatomic structure. It approximated desired implant position but visualization of of the ______is ______by the surgeon during placement. There are computer based ct generated planning software that take into account the desired restoration with the ct image bone and anatomic structure and allow for precision placement the dental implant.

Hope this helps!!