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ePaper created 2015-09-15, 12:06:46 | version 1.38.0
_Although osseointegration of dental im- plants is predictable, thorough preoperative plan- ning is a prerequisite for a successful treatment outcome.1, 2 Anatomic limitations and prosthetic considerations encourage the surgeon to obtain a very precise positioning of the implants. Histori- cally, standard radiographic imaging techniques (intra-oral and panoramic) were available for in- vestigation of potential implant sites. Nowadays,itiswellknownthat3-DCTscansal- low for more reliable treatment planning than when only 2-D data is available.3 Transforming the CT scan images into a 3-D virtual image can be achieved using computer software packages, al- lowing for a 3-D view using CAD technology.3 For years, stereolithographic guided surgery appeared to be the gold standard in computer-guided im- plant surgery. This technique has been well devel- oped in recent years and several scientific reports havebeenpublishedregardingaccuracy,complica- tions, survival and success.4 However, stereolitho- graphic guided surgery has some major disadvan- tages compared with conventional implant sur- gery. The surgeon has to rely on a predesigned tra- jectoryplannedinthesoftware,withoutbeingable to make intra-operative adjustments. In addition, the loss of tactile feeling during preparation and implant placement is a major drawback. Real-time navigation appears to be a valuable alternative to stereolithographic (static) guided surgery, as it offers the clinician some advantages over the former technique. Using real-time (dy- namic)navigation,onecanavoidthefabricationof astereolithographictemplate,resultinginalessex- pensive treatment. As navigation is considered a dynamic guided surgery system, changes to the treatment planning (location and size of implants, number of implants, flap or flapless, etc.) can easily be made intra-operatively. Also, the tactile feeling during the drilling procedure, as well as manual control over the implant stability, is still present when using navigation surgery. Over the last decade, there has been a shift in surgical and prosthetic protocols, resulting in sig- nificant reduction in the integration time of a den- talimplant.Thisisalogicalconsequenceofthecon- stant improvement of implant characteristics and components simplifying dental implant treatment. Guided surgery using implant simulation software can contribute to better treatment planning, as it provides a preoperative view of the anatomical structures related to the future prosthodontics.5 Thisfactcouldmakeimmediateloadingprocedures easier, and allows the clinician to know in advance the potential location and dimension of the future restoration(s).Manyguidedsurgeryproceduresre- I case report Figs. 1a & b_The NaviStent surgical stent. Fig. 2_Pre-op panoramic image. Immediate loading with dynamic navigation implant surgery Authors_Dr Jan D’haese, Dr Johan Ackhurst & Prof. Hugo De Bruyn 34 I implants3_2015 Fig. 1a Fig. 1b Fig. 2