Sirona Technology Leads the Way to Safer, More Predictable Implant Placement
August de Oliveira, DDS, marvels at the changes that have occurred in implantology, especially innovations that have made what is increasingly considered standard of care both more predictable and more affordable.
Three-dimensional (3-D) cone beam computed tomography (CBCT) x-rays and guided surgery, he says, have improved the dental implant procedure, making it safer and more effective, which, in turn, allows doctors to feel more confident about joining the growing number of their colleagues who place implants. “With a CBCT scan, dentists know exactly where the patient’s anatomy is, the size and number of implants to use, whether the case should be referred, and even if implants are right for the patient,” de Oliveira explains. Further, he says, “CBCT-generated surgical guides ensure that the implant will be placed exactly where it needs to be for the restoration (crown) while also avoiding nerves or other anatomic structures.”
As for cost, he says, the competition among the increasing number of companies selling implants has been a boon for dentists and their patients, who have benefitted from the resulting affordability of the implants and equipment.
But the real game changer, says de Oliveira, is the new “world of information” now available from optical scan data from equipment such as Sirona Dental’s CEREC®. “A tooth form can be used in the scan to determine the optimal position of the implant. Soft-tissue data can be overlaid at the same time so that the implant can be placed in a way to develop proper emergence profile. ‘Noise’ that is typically generated from metal in the patient’s crowns or metal substructures can be reduced and overlaid with the optical data from CEREC to provide very clear and accurate tooth and soft-tissue surfaces.” Add to that new software, he says, abutments and even surgical guides can be fabricated with the CEREC CAD/CAM system.
de Oliveira describes the three surgical guide options from Sirona: Classic Guide, Optiguide, and CEREC Guide. “With Classic Guide, the surgical guide is a modification of the radiographic guide, which is usually just a premade biteplate with integrated fiducial glass markers that the patient bites into with PVS bite registration. Because the biteplate serves as a final component of the manufactured surgical guide, the custom fit of the surgical guide is reproduced just as it was placed by the staff on the patient in the office.”
Optiguide, he continues, allows dentists to scan the patient with CEREC and Sirona 3D CBCT and upload this data to Sirona via the Internet, saving time and a physical impression. de Oliveira says both he and his patients appreciate the convenience and accuracy afforded by the CEREC Guide, which, he notes, is currently the only chairside milled surgical guide in the market. “It is not uncommon for a patient in my office to have the entire guided implant procedure done in less than an hour,” he states.
Sirona offers those who purchase its 3-D solutions (both GALILEOS and ORTHOPHOS XG 3D) a unique training package, de Oliveira adds. The offer includes two phases of in-office training and an intensive 2-day course covering both the 3-D radiology and guided implant software by specialized clinicians. Online training support is also available (www.sirona3D.com).
de Oliveira believes the field of implantology—along with innovations from Sirona—will continue to progress. “With the new GALILEOS ComfortPlus with integrated FaceScanner, we can now place implants in harmony with the patient’s smile line,” he explains. “With greater integration with CEREC, I am sure we will be able to mill out temporaries or even the final restoration based on the plan in GALILEOS.” He adds that with advances in CEREC inLab, intraoral impressions on fully edentulous cases will allow the final prosthesis to be fabricated in less time and with greater accuracy than traditional PVS impressions with lab analogs.
“It truly boggles the mind what Sirona is doing for implants, crowns, and guided implantology,” he concludes.
Sirona Dental Inc.
4835 Sirona Dr, Suite 100
Charlotte, NC 28273