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Implant Surgery with the application of surgical guide

With the development of digital implant technology, the application of intraoral scanning and surgical guide is becoming more and more popular. In implant surgery, the accuracy and efficiency can be improved by printing the personalized surgical guide that consistent with patient’s intraoral condition according to the intraoral data.

Patient information

The patient had both side of the lower posterior teeth missing for 4 years and CBCT show that #44 root canal had high density ray blocking substance; low density shadow in the root tip; complete absorption in the labial bone wall of the root. #45 top of the ridge had a 1mm diameter residual root, #45, #47, #34, #36 width of alveolar ridge was moderate.

Workflow of the implant surgery

Obtain the digital impression

Acquire intraoral data with Aoralscan for the subsequent surgical guide design.

Treatment plan

Place implant with 4.8*10 in tooth position #36, #47 according to the actual bone mass; due to sufficient vertical bone mass, implants with 4*12 & 4.3*12 will be placed in tooth position #34, #45; after surgery, #44 (residual root) will be extracted for delayed implant placement.

Design surgical guide

Because the surgical guide generated by software is indivisible, and the span of guide is large, which is difficult to be in position. Therefore, the guide will be segmented into 2 parts by a third software to facilitate the surgeons to remove the guide during the operation.

Print surgical guide

Print surgical guide with dental 3D printer AccuFab

Implant surgery

preoperative intraoral condition
surgical guide try-in
preparation of implant bed
place the implant
extract residual root
place gelatin sponge into the residual root area
postoperative intraoral photos

Postoperative CT examination

Due to the irregular shape of the alveolar ridge, the absorption of labial bone on #34, insufficient width of alveolar ridge and uneven bone density at the implant bed area, in addition, the patient has a certain degree of mouth opening limitation, manual operation may lead to poor orientation and affect the final restoration. With the help of surgical guide, the orientation and depth can be precisely controlled and, more importantly, it’s minimally invasive and it can also reduce the operation time and the fear of patient in the process of surgery.