Traditional dental x-rays most often do not provide sufficient information on the shape and amount of bone to predict the prosthetic outcome of implant treatment. By using a barium-coated template, which depicts final prosthetic outcome, a precise determination of the final restoration can be determined. (published references) This allows the restorative dentist to have meaningful prosthetic input during all phases of treatment. In preparation for the CAT Scan x-ray, a plastic appliance is fabricated. The patient wears this appliance during the CAT Scan. This allows prosthetic information to be incorporated on the CAT Scan. Once the medical radiologist processes the scan, it is sent to the requesting doctor for interpretation and planning. The study can be analyzed on a computer using software program called Sim/plant. Many restorative doctors have incorporated this technology in their office. The jawbone can be viewed three dimensionally. It becomes easy to determine the height, width and density of the bone, and the location of the mandibular nerve and maxillary sinus. Surgical simulations can be done on the computer, so the exact size and ideal location for the implant is known. In essence, your treatment is completed on the simulator pre-surgically. Recent computer technology breakthroughs enable a surgical guide to be electronically constructed to guide implant placement during surgery.
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Sim/plant overview showing the lower jaw from the front, top, and in cross-section slices. A 3-D view is also shown.
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With Sim/plant, the height and width of the bone can be measured, and anatomical structures visualized. Here the mandibular nerve is identified and highlighted in red, and implant simulations are inserted to preview implant placement.
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Close-up of side view of the lower jaw, with the mandibular nerve highlighted in red. Implant length and width simulation can determine final size needed.
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Close-up of the occlusal view of lower jaw, showing natural teeth and simulation of 2 planned implants.
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The cross-section view allows for determination of the implant width and length, and placement angle. Here, the proposed abutment is also shown.
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The density of the bone can be seen, to evaluate if implants are feasible. The abutment post size and angle can be measured to help in planning for restorations (crowns).
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The most challenging aspects of treatment are accurate diagnosis, treatment planning determining the outcome and patient satisfaction.