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18 IMPLANT TRENDS Implant Tribune United Kingdom Edition | 5+6/2017 Dynamic navigation for precise implantation in cases of critical anatomy By Dr David Burgess, UK Introduction Using the CBCT image as a map, dynamic navigation guides sur- geons just like a GPS guides driv- ers. The clinician virtually plans where implants should be placed. During surgery, the navigation system dynamically tracks the drill and the patient’s jaw, provid- ing guidance and visual feedback to ensure the implants are placed according to plan. There are several advan- tages with dynamic navigation. The technology allows clini- cians to place implants more ac- curately than free-hand. This results in improved safety and aesthetics, as it helps the clini- cian to anticipate and to avoid potential complications. Other advantages are the ability to have more minimal invasive treatments, which means less chair time, less patient discom- fort and less recovery time. This treatment option has generally been seen as a “blind” proce- dure in the past, but the ability to avoid delicate anatomical structures due to the real-time surgical feedback makes so- called flapless surgery a valua- ble option. In the following case report, Dr David Burgess describes how using computer-guided dynamic navigation helped him overcome clinical chal- lenges for dental implant place- ment in the lower posterior re- gion. is holding Info four Dr Burgess hands-on courses in 2017 for expe- rienced implant dentists who want to incorporate dynamic navi- gation into their digital workflow. For further information, course reservations or other related re- quests, e-mail: dns@claronav.com previously been able to, using con- ventional protocols. Whilst there is no physical guide, a simple scan- ning template (NaviStent) is used to hold the fiducial in place whilst taking the CT scan, and secure the jaw reference (JawTag) for the navigated osteotomy. In this case, the NaviStent was fabricated, the fiducial marker at- tached and a CBCT scan taken two weeks prior to surgery (Fig. 2). The treatment plan was created imme- diately after the scan (Fig. 3), with the patient present. He was able to see the proposed treatment dis- played by the Navident software and appreciated that great care was being taken to achieve the opti- mum implant positioning, with minimal risk of potential compli- cations (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 anaesthesia. Prior to preparation of the implant sites, AD Case report A 75-year-old male patient had endured a gap for five years, following removal of his lower left second molar, due to an acute apical infection. He was finding mastication increas- ingly difficult and sought ad- vice about the treatment op- tions available. Planning for optimum implant positioning As there was no tooth distal to the space, conventional fixed bridgework was not possible. The treatment options were either a unilateral single saddle lower par- tial denture or restoration of the space with two dental implants. The patient chose to have dental implant treatment as he did not wish to have any form of remova- ble prosthesis. What makes Navident dy- namic 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 Dental Tribune International ESSENTIAL DENTAL MEDIA www.dental-tribune.com