CAD/CAM - international magazine of digital dentistry

Step1 3-D radiographic diagnostics are performed without any template. An intraoral surface scan (iTero™) supplements the imaging sequence. The scan allows the generation of a high-resolution portable STL file (Surface Tesselation Language) of the intraoral patient situation (Figs. 2a–c). Step2 TheDICOMdataandtheSTLfileareimplemented and superimposed in the CoDiagnostiX planning software. A virtual set-up of the prosthetic re- construction, as well as a surgical template with optimal 3-D implant positioning can be realized using a restoration-driven backward planning con- cept, whilst considering the individual anatomical situation (Fig. 3). Once the planning phase is finished in CoDiagnostiX, a 3-D printer can plot the virtual constructionofthesurgicaltemplatewiththerapid prototypingtechniquewithouttheneedofanyphy- sical model. Finally, CoDiagnostiX delivers an indi- vidualdrillingprotocolwithsequencedCAISinstru- mentsforasafe3-Dimplantplacement(Fig.4a&b). _Surgery Step3 Prior to implant surgery, the plotted template is checked for a gap-free fit in the patient’s mouth. Built-in viewing windows adjacent to the implant siteandincontralateralpositionimprovethelevelof control that can be clinically achieved (Figs. 5a & b). After anesthesia and soft tissue punch, the cortical boneisperforatedwitharoundburincentralposition. I 17 case report _ guided surgery I CAD/CAM 4_2013 Fig. 4a Fig. 4bFig. 3 Fig. 6bFig. 6a Fig. 5bFig. 5a