From Conventional to Complex Treatments, Digital Technologies Are Simplifying Implant Dentistry.

In the past decade, the shifting of dentistry into the digital world has become obvious to any dentist or dental specialist. Many restorative dentists now consider themselves "digital dentists," performing all their crown and bridge restorative planning and fabrication in a digital environment. In preparation for this article, the author asked both a prosthodontist and the owner of a large state-of-the-art dental laboratory with whom he has worked closely the following questions: "These days, what percentage of your crown and bridge cases are being done fully digital?" Then, "What is the answer to the same question 5 years ago?" The prosthodontist answered that for crowns and bridges (with some exceptions for bridges), including implants (but not full arches), "close to 100 percent" of cases are now fully digital, while "maybe 25 percent" were 5 years ago (personal communication with Jason Sauer, DDS, of Westchester Prosthodontics, White Plains, New York, March 29, 2024).

Elevoplasty®: An Innovative, Minimally Invasive Procedure for the Treatment of Snoring.

For non-obstructive sleep apnea diagnosed patients with predominantly palatal snoring, Elevoplasty® is an efficient, minimally invasive treatment option. Aimed at reducing snoring severity, the innovative procedure involves the placement of three to four small resorbable polydioxanone barbed sutures, which are buried in the tissues of the soft palate. After placement, the sutures are "activated" by a gentle pull, which provides a "lift" of the soft palatal tissues and uvula.

Coronectomy: An Alternative to Complicated Full-Bony Impacted Tooth Removal.

The removal of impacted teeth is a common office-based oral and maxillofacial surgical procedure. Complications associated with the procedure are uncommon; however, in the mandible, close proximity of the third molars to the inferior alveolar nerve can potentially lead to temporary or permanent sensory disturbances. The intentional partial odontectomy (coronectomy) procedure is a surgical option aimed at mitigating and reducing the incidence of this potential risk and complication.

Immediate Loading: Are Implant Surface and Thread Design More Important Than Osteotomy Preparation?

The design and development of today's dental implants has been an evolving process based on scientific research, clinician input, and manufacturer ingenuity. Newer tapered implants with aggressive thread designs allow for placement at greater torque values than in the past, with high levels of initial stability even in situations with low-density or compromised bone. Modern implants are designed for patient cases involving extraction, immediate placement, and immediate load, as well as cases with less-than-ideal bone volume and quality.

Is a Fully Digital Dental Implant Treatment Solution a Real Possibility in 2020?

Digital implant workflows are facilitating new and more accurate methods of implant treatment planning when compared to conventional analog techniques. The placement of implants using guided surgery presents multiple benefits for immediately restoring a patient functionally and esthetically with a provisional restoration. Although digital technology enables efficiency and enhanced accuracy for dental implant treatments, some cases may require the use of a hybrid workflow that employs both conventional and digital procedures, as some limitations to a fully digital approach exist depending on the clinical situation.

Computer-Guided Dental Implant Treatment of Complete Arch Restoration of Edentulous and Terminal Dentition Patients.

The treatment of completely edentulous or soon-to-be completely edentulous dental arches with complete-arch fixed denture restorations, supported by dental implants, are some of the more complicated patient cases in oral and maxillofacial surgery and prosthodontics. This article discusses the use of digital technologies, computerized tomographic (CT) guided planning software applications, and surgical guides in treating these complex dental implant patient cases. A discussion of the nuances and workflows of different types of treatments are provided.

Ten Myths of Guided Implant Surgery.

Since their introduction, guided dental implant planning and surgery procedures, like most new techniques in medicine and dentistry, have undergone many modifications and advances. While some practitioners were early adopters, most dental surgeons have been cautious regarding this methodology. Despite more than a decade of literature, podium presentations, advances in instrumentation and technique, and successful cases, questions remain within the dental surgical community.

What's Hindering Dentistry From the Widespread Adoption of CT-Guided Surgery?

Although computed tomography (CT)-guided technology has been shown to increase implant placement accuracy, decrease surgical complications, and improve the predictability of implant case outcome, many in the dental implant community continue to resist using it for three main reasons: time, money, and fear. While it is true that there are additional preparatory steps necessary in patient case planning and the practitioner must invest in unfamiliar technologies and overcome a learning curve, increased efficiency, improved restorative outcomes, and clear benefits to both patients and practitioners make a strong case for adopting this approach.

Cumulative survival rate of implants placed "fully guided" using CT-guided surgery: a 7-year retrospective study.

Purpose: To evaluate the cumulative survival rates (CSRs) of dental implants placed "fully guided" using computed tomography (CT)-guided surgery, including cone beam CT (CBCT).

Materials And Methods: Records, mountings, wax-ups, and scanning appliances were made for patients to wear during CT/CBCT scans following established manufacturer-guided surgery protocols. Virtual planning was performed using either the NobelProcera/NobelClinician or the SimPlant/Facilitate softwares.

Implant complications: biomechanical and esthetic considerations--a prosthodontist's perspective.

Implant placement has continued to gain acceptance as a viable solution for the treatment of missing teeth, serving as an alternative to dentures or bridges. However, clinicians must be aware of and capable of handling complications that may accompany the placement of dental implants. Complications can range from prosthetic problems stemming from misalignment of implants, to fixed removable prosthesis-related complications, to screw-connection impediments.

Combining All-on-4 treatment with CT-guided technology: technique and report of three cases.

No longer merely a concept for the future, the use of digital technologies in dentistry has become common practice today. Computed tomography (CT)-guided dental implant surgery has greatly expanded over the past decade as concepts and techniques have become increasingly refined and more implant manufacturers have adapted their implant systems to these new technologies. The All-on-4® technique for dental implant placement and restoration, while developed some two decades ago, has recently generated increased interest as a highly functional, esthetic, cost-effective alternative for a large group of patients who could benefit from a full-arch, implant-supported fixed restoration.

Cavernous sinus thrombosis as a result of a fungal infection: a case report.

Cavernous sinus thrombosis (CST) is a rare disease with the potential for significant morbidity and even death. Rapid diagnosis and aggressive medical and surgical management are imperative for patients with CST. The cause may be aseptic or infectious.

Comparison of the accuracy of cone beam computed tomography and medical computed tomography: implications for clinical diagnostics with guided surgery.

Purpose: This study compared the accuracy of cone beam computed tomography (CBCT) and medical-grade CT in the context of evaluating the diagnostic value and accuracy of fiducial marker localization for reference marker-based guided surgery systems.

Materials And Methods: Cadaver mandibles with attached radiopaque gutta-percha markers, as well as glass balls and composite cylinders of known dimensions, were measured manually with a highly accurate digital caliper. The objects were then scanned using a medical-grade CT scanner (Philips Brilliance 64) and five different CBCT scanners (Sirona Galileos, Morita 3D Accuitomo 80, Vatech PaX-Reve3D, 3M Imtech Iluma, and Planmeca ProMax 3D).

Computer-guided implant surgery: indications and guidelines for use.

The introduction of medical-grade computed tomography (CT) technologies and the ballooning use of cone beam CT (CBCT) in dental offices, in combination with the use of proprietary dental implant software, has revolutionized the planning and placement of dental implants. These technologies facilitate a team approach in a truly restoratively driven treatment plan based on the accurate planning and placement of dental implants. Using this approach, the planned restoration for an implant site is first created; then the dental team, in effect, works backwards to virtually plan the ideal implant position for the site based on the anatomy, vital structures in the area, surrounding and opposing teeth and restorations, and the restoration planned.

Application and success of two stereolithographic surgical guide systems for implant placement with immediate loading.

Purpose: Two different stereolithographic surgical guide systems, NobelGuide (Nobel Biocare) and SimPlant (Materialise), were compared clinically, and the survival rates of the planned immediately loaded dental implants with prefabricated provisional restorations were evaluated.

Materials And Methods: Patients were treated with implants using either the Materialise SimPlant system or the Nobel Biocare system. All implants were planned on cone beam computed tomography (CBCT) or CT-derived images.

An open system approach for surgical guide production.

Purpose: Surgical guides for oral implantology were made with a new open system independent of implant planning software based on a universal computed tomography/cone beam computed tomography (CBCT) scan plate for fiducial markers.

Materials & Methods: For this in vitro study, CBCT scans were taken of 18 models based on a universal computed tomography/CBCT scan plate (Bego Medical, Bremen, Germany) for fiducial markers. The models were made from radiopaque composite with several integrated radiopaque gutta-percha points used as a reference.

Guided surgery for implant therapy.

New three-dimensional diagnostic and treatment planning technologies in implant dentistry have expanded on concepts of a team approach to the planning and placement of dental implants. The accurate and predictable placement of implants according to a computer-generated virtual treatment plan is now a reality, taking the virtual plan from the computer to the patient clinically. Recent advances in three-dimensional imaging in dentistry, in combination with the introduction of third-party proprietary implant planning software and associated surgical instrumentation, have revolutionized dental implant diagnosis and treatment and created an interdisciplinary environment in which communication leads to better patient care and outcomes.

The use of 3-dimensional imaging in dentoalveolar surgery.

In the past decade, many different cone-beam volumetric tomography (CBVT/CBCT) machines have been introduced to the dental market with varying features. While medical-grade CT is still considered the "gold standard" for CT accuracy and diagnosis, CBCT, because of its convenience, lower radiation, and smaller machine footprints, has become more commonplace in dental surgical offices. This article discusses the use of CBCT technologies along with proprietary implant software programs in dentoalveolar surgery.