implants - international magazine of oral implantology

I industry report Fig. 1_Current clinical cases as examples for inadequate 3-D diagnostics and manual placement: a) Implants in the third quadrant and the region of tooth 47 are impacted completely; those in the regions of teeth 37 and 47 have penetrated the mandibular nerve canal. These image sections show orthogonal alveolar ridge sections through the centres of the implants. b) Implants in the regions of teeth 35 and 45 have been fully inserted into the mental foramen. The mandibular nerve has a lesion in region 46. _Introduction Every day we hear about new curative procedures and their successful application in therapy. The new media broadcast information about medical per- formances worldwide instantly to wide sections of the population. This environment places greater de- mands on us, the operators, to meet our patients’ in- creasing expectations for high quality. It is increasingly less feasible for a “universal ge- nius” to perform complex dental medical therapy alone—consistent interdisciplinary cooperation has becomeessential.Diagnosticsandtherapystrategies are necessary and increasingly extensive prerequi- sites which must be carried out prior to the actual manualdentalprocedures.Advanceplanningofther- apeutic measures as well as the continuous use of treatment procedures and working instructions with regardtoaqualitymanagementsystemformtheba- sis for successful complex oral rehabilitations. Three-dimensional imaging procedures, upon which dental diagnostics and implant navigation are based, are an important component. Navigation pro- cedures are considered established methods in im- plantology.Althoughtheyhavebeeninuseforalmost 20years,colleaguescontinuetodisagreeaboutthem vehemently even today. Comments range from “no need” and “won’t work anyway” to “I cannot do with- out them”. For 3-D diagnostics and implant planning, meet- ing the requirements by processing and evaluating 3-D radiographic data is essential. In dentistry, cone- beam computed tomography is increasingly used as the source for 3-D radiological image data. In its guidelines 2005: Cone-beam computed to- mography (CBCT)—S1—Recommendation and 2012: Indications for implantological 3-D radiographic di- agnostics and navigation-guided implantology—S2k guideline, DGZMK (German Society of Dental, Oral and Craniomandibular Sciences) debates this topic fundamentally. Not only are the technical principles, prerequisites and indications summarised and com- mented on, but they also discuss the currently feasi- ble results when using navigation-guided implanta- tion. The few in vivo data available show that devia- tions of 2.4 mm in 2005 at the implant tip appear to Safe interdisciplinary navigation Authors_Dr Frank Schaefer, Dr Dagmar Schaefer, Dr Mike C. Zäuner & Master Dental Technician Jürgen Sieger 36 I implants3_2013 Fig. 1a Fig. 1b