Dynamic Implant Planning
Advanced digital workflows are transforming implant dentistry with precise, restoratively driven treatment planning. By merging CBCT scans with intraoral scans and using dynamic navigation systems, clinicians gain unmatched control and accuracy from virtual crown to final placement.
Digital integration in implant planning begins with acquiring “digital imaging and communications in medicine” (DICOM) data from cone-beam computed tomography (CBCT) scans, setting the stage for a fully guided and customized procedure.
Once the DICOM data are obtained from the CBCT, the images are uploaded into the treatment planning software. A panoramic curve of the arch needing implants is developed on the axial plane of the CBCT scan. On the mandible, the inferior alveolar nerve can be traced. When available, IOS images of the patient can be merged into the DICOM data to allow better soft tissue evaluation. A virtual crown can also be added to allow for restoratively driven implant planning. The software allows for generic implant placement or the choice to customize the size of the implant and abutment height/angle (Figure 1).
Calibration, Registration, and System Check
Calibration is the process that the dynamic navigation system uses to register the tools and patient anatomy in reference to the CBCT scan and virtual implant plan. The geometry of the passive reflective elements on the patient and handpiece trackers allows them to be detected by the stereoscopic optical cameras as shown in Figure 2. The parts need to be assembled and then placed in front of the optical cameras to allow the software to “learn” their geometry. The calibration process usually occurs at 60 to 80 cm from the camera. The calibration involves the handpiece calibration and the X-clip calibration/registration.
With the calibration of tools and accurate registration of patient anatomy, the dynamic navigation system ensures surgical precision. These innovations not only enhance outcomes but also elevate the standard of care in implant dentistry.
This originally appeared in AlQallaf H, Lin SW, Polido W, Yang CC. Exploring dynamic computer-assisted implant surgery. Decisions in Dentistry. 2024;10(6):32-35.
