CAD/CAM – international magazine of digital dentistry No. 2, 2017

dynamic navigation cone beam supplement | Fig. 1 Fig. 2 Fig. 3 Fig. 4 CAD/CAM 2 2017 43 Fig. 1: An illustrative image of Dr Burgess using Navident. – Fig. 2: A CBCT scan was taken two weeks prior to surgery. – Fig. 3: The treatment plan was created immediately after the scan. – Fig. 4: The patient was able to see the proposed treatment displayed by the Navident software. dental implant treatment as he did not wish to have any form of removable prosthesis. What makes Navident dynamic navigation stand out is it precisely guides the surgeon to prepare and place the implant in a pre-determined position (Fig. 1). This allows me to achieve greater accuracy and certainty than I have previously been able to, using conventional protocols. Whilst there is no physical guide, a simple scanning template (NaviStent) is used to hold the fiducial in place whilst taking the CT scan, and secure the jaw refer- ence (JawTag) for the navigated osteotomy. In this case, the NaviStent was fabricated, the fi- ducial marker attached and a CBCT scan taken two weeks prior to surgery (Fig. 2). The treatment plan was created immediately after the scan (Fig. 3), with the patient present. He was able to see the proposed treatment displayed by the Navident software and appreciated that great care was being taken to achieve the optimum implant positioning, with minimal risk of potential complications (Fig. 4). The patient was impressed with, and reassured by, the state-of-the-art technology. Confidence from continuous feedback Treatment was carried out under local anaesthe- sia. Prior to preparation of the implant sites, the simple Navident protocol for calibration and verifi- cation of the drill axis and drill tip was carried out. A crestal incision was made, with a minimal flap re- flected. The software shows the drill position on the scan in real time, as it enters the jaw. This allows adjustments to be made, if necessary, whilst the

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