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implants UK - the journal of oral implantology

10 I I case report_ CT-guided implant surgery implants1_2011 to have a CT scan, have the scan redone should the technician not have followed the protocol exactly, import the DICOM files into the software program, clean up the scatter, treatment plan the implants, and then see the patient for a second consultation to review the treatment plan. Because of the significant time and effort required to complete a computerised treatmentplan,Igenerallyreservedthisprocessforthe more complicated cases or those for which accurate implant placement was critical. Most cases were done the‘old-fashionedway’duringthisperiod. My next revelation came in 2007, when I first saw the GALILEOS cone-beam computed tomography (CBCT)scannerandstartedthinkingaboutincorporat- ing this into my practice. The beauty of it was not the scanner itself, as most CBCT scanners on the market render a good image; it was the software. GALAXIS and GALILEOS Implant were developed with the dentist in mind, as opposed to most other CT viewing and implant- planning programmes, which were modified from exist- ing medical CT software. With verylittleinstruction,Iwasableto navigate through the images and start planning implant surgery likeanexpert. Sirona, the manufacturer of GALILEOS, hit a home run, in my opinion, when they considered the entire work flow in design- ing the software suite that was included with their machine. With the simple click of a tab, the same software programme used for viewing the scan diagnostically could quickly and easilybeusedfortreatmentplanningimplants,and thenorderingacustomsurgicalguide. Once I had brought GALILEOS into my office, life became easier. Now, as soon as my patient was scanned, using a radiographic template, the images could be brought up on the monitor, and then implant planning could begin immediately. What previously took at least 30 minutes of my time and two patient visits was now possible in less than five minutes in a single appointment. As a result, cases that I previously considered to be too simple to treat using CT-guided surgery techniques were now suitable candidates. Before I knew it, I was utilising this technology for practically every implant case. The onlyexceptionwasacaseinwhichapatientcouldnot wait the seven working days that it currently takes to have the surgical guide manufactured. CT-guided implantsurgeryhasthebenefitsofincreasedaccuracy of implant placement through a smaller, minimally invasiveincision.Anothermajorbenefittotheimplant surgeon is decreased surgical time, which allows one toschedulemorepatientsandmoreproceduresinthe day.Ofcourse,thisisoflittlebenefitiftreatmentplan- ningbecomesverytime-intensive.Thebeautyofthe Fig. 3_CEREC 3D virtual model with proposal of provisonal restoration. Fig. 4_GGALLILEOS treatment planning reprt demonstrating position of implant in relationship to existing restoration. Fig. 3 Fig. 4 Fig. 5_Placement of implant through siCAT surgical guide using Facilities Surgical Guide. Fig.6_Provisional abutment attached to immediately placed impant. Fig.7_Provisional crown on imaplant immediately after placement. Fig. 5 Fig. 6 Fig.7