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ePaper created 2015-05-29, 13:18:43 | version 1.38.0
technique _ virtual planning I plants are confirmed for the edentulous presen- tation, a mucosal-supported template can be designed and fabricated through 3-D printing, stereolithography, or a CAD/CAM process. The mucosal-supported template should be fixated to the bone, to insure accuracy of the drilling se- quence. The template with the blue screws can be visualized in Figures 20a–c. _Conclusion The advent of complete denture fabrication evolved into the adoption of over-denture con- cepts for both natural and implant supported restorations. Conventional prosthodontic proto- cols were developed to aid in the diagnosis, treat- ment planning, and laboratory phase of the recon- struction. These included conventional periapical radiographs, panoramic radiographs, oral exam- ination, and mounted, articulated study casts. The clinician was then expected to assess several importantaspectsofthepatient’sanatomicalpres- entation including vertical dimension of occlusion, lip support, phonetics, smile line, overjet, overbite, ridge contours, and a basic understanding of the underlying bone structures. The accumulation of preliminary data afforded by conventional diag- nostics provided a foundation to prepare a course of treatment for the patient. However, the conven- tional review of findings was based upon a two- dimensional assessment of the actual patient’s bone anatomy. To fully understand each individual patient’s presentation, this article provided clini- cians with an appreciation of various innovative virtual,three-dimensionaltoolsbasedupontheuse of advanced three dimensional imaging modalities for both removable and fixed prosthetic treatment alternatives. The application of CBCT and interactive treat- ment planning software, empowers clinicians with an accurate understanding of the three-dimen- sional anatomic reality for our patients as an aid in providing state-of-the-art treatment. Implants will be better positioned, with fewer surgical and restorative complications, and reduced laboratory remakes based upon these improved diagnostic tools. The benefits will enable clinicians to better understand the relationship between patient anatomy and the desired restorative outcomes, in the process of achieving true restorative driven implant reconstruction. The ability to utilize digital imagingandtreatmentplanningtechnologyisnow within the reach of most clinicians through the various software products that are on the market. In addition there are many third party outlets through internet portals that enable clinicians to upload their DICOM data for evaluation, process- ing, treatment planning, and even surgical tem- plate fabrication without actually owning the planning software. New paradigms have been es- tablished that in the author’s opinion will continue to redefine the process of diagnosis and treatment planning dental implant procedures, both remov- ableandfixedalternativesforyearstocome.Please remember though that the “template is only as good as the plan”._ Figs. 20a–c_The template design revealing the guide tubes (a); three blue fixation pins (b); and the entire complex on the 3-D reconstructed volume (c). I 11cone beam2_2015 Fig. 20a Fig. 20b Fig. 20c Dr Scott D.Ganz maintains a private practice for prosthodontics, maxillofacial prosthetics,and implant dentistry in Fort Lee,New Jersey,USA.He has served as President of the NJ Section of theAmerican College of Prosthodontists and the ComputerAided Implan- tologyAcademy (CAI).He has served as President of the New Jersey Section of theAmerican College of Prosthodontists and of the ComputerAided ImplantologyAcademy. Dr Ganz delivers presentations worldwide on both the surgical and restorative phases of implant dentistry,and has published extensively on these topics.He is considered one ofAmerica’s leading experts in the evolution of computer utilisation and interactive software for diagnostic and treatment planning applications using CT and newer- generation CBCT imaging modalities. cone beam_about the author