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First Page PDF
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I m p l a n t Tre a t m e n t o f
C o m p l e t e A rc h R e s t o r a t i o n of
Edentulous and Terminal
Dentition Patients
Gary Orentlicher, DMDa,b,*, Andrew Horowitz, DMD, MDa,b,
Leonard Kobren, DDSc
KEYWORDS
Computer-guided dental implants Minimally invasive Guided surgery workflow
Complete-arch dental implant treatment CT guided surgery Surgical guides
KEY POINTS
Computerized tomography (CT)-guided implant planning and treatment workflows were developed
to improve the accuracy and precision of dental implant placement while placing implants in a mini-
mally invasive manner.
The ability to import intraoral and/or dental impression or model optical scan Standard Triangula-
tion Language (STL) data into CT-guided planning software applications, and to overlay that data
over the medical CT and conebeam CT Digital Imaging and Communications in Medicine (DICOM)
images, has simplified and expanded the workflow.
Recently introduced complete-arch treatment workflows using 3 implants with stock metal bars
and adjustable abutments, as well as techniques using stackable bone reduction guides, implant
placement guides, and digitally planned and milled provisional restorations, fabricated prior to
implant placement surgery, have added to the options for treatment.
Computer-guided implant planning and treat- tissue. Some clinicians have advocated implant
ment workflows were developed to improve the placement using flapless techniques, either
accuracy and precision of dental implant place- with or without initial visualization of the
ment while placing implants in a minimally inva- underlying anatomy using 3-dimensional (3D)
sive manner.1–8 Placing implants in this way radiographic evaluation. The clinical challenge
reduces tissue trauma, decreases patient post- of a flapless nonguided approach is significant,
operative pain and swelling, improves patient requiring careful 3D position assessment, intui-
postoperative experiences and may improve pa- tion, and experience. With the introduction in
tient case outcome. Dental implants are the early 2000s of computerized tomographic
commonly placed under direct visualization of (CT)-guided dental implant planning software
oralmaxsurgery.theclinics.com
the osseous bed following elevation of soft- and workflows, the fabrication of corresponding
Disclosure Statement: Dr G. Orentlicher has received honoraria for speaking for NobelBiocare. Dr L. Kobren has
received honoraria for speaking for Dentsply Sirona. Dr A. Horowitz has nothing to disclose.
a
Private Practice, New York Oral, Maxillofacial, and Implant Surgery, 495 Central Park Avenue, Scarsdale, NY
10583, USA; b Oral and Maxillofacial Surgery, White Plains Hospital, White Plains, NY, USA; c Private Practice,
Westchester Prosthodontics, 12 Old Mamaroneck Road, White Plains, NY 10605, USA
* Corresponding author.
E-mail address: [email protected]