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ePaper created 2017-12-06, 11:14:19 | version 1.38.0
| industry Dynamic navigation in fully edentulous maxilla Authors: Prof. Dr Hakan Uysal & Dr Noyan Bas¸ al, Turkey Literature Preoperative planning is the most important part of a successful implant rehabilitation and requires multiple parameters to be considered for the precise placement of implants. The implants should be placed not only within anatomical boundaries but also be strategically located to support a prosthesis that will fulfil both functional and aesthetic requirements. 3-D virtual images are being used through com- puter software, which transforms CBCT scans into 3-D virtual models. However, after a precise planning or virtual realisation of the treatment, the osteotomy should also be executed precisely according to the plan and would likely require guidance of the drills and the implant. For years, stereolithographic static guides have been used successfully for implant osteotomies, us- ing detailed information implemented through 3-D virtual images.1, 2 Static guides on the other hand pres- ent several disadvantages. The loss of tactile feeling during osteotomy and the fact of being limited to the predesigned drilling trajectory are considered to be their major drawbacks. Real-time navigation A recent technology, which provides dynamic guidance through a real-time navigation for implant osteotomy, offers not only accuracy, but also addi- tional valuable advantages during an operation.3, 4 With this technology, the location and diameter of implants can be modified and a flap can be incised intraoperatively whenever needed. Furthermore, dynamic navigation enables the sur- geon to adjust the surgical plan during surgery. In case of an unexpected low bone quality, an additional implant could be planned with the software and placed additionally. Moreover, one of the most signif- icant benefits of dynamic navigation is the ability to use it also for alveoloplasty and reshape the alveolar crest’s topography during the same surgery, together with the implant placement. Fig. 1: Patient wants a screw- retained fixed prosthesis. Fig. 2: Radio-opaque tooth set-up for prosthetic planning. Fig. 3: Scan prosthesis at try-in to check its fit, aesthetics and maxilla mandibular relation. Figs. 4a & b: Navident H-Arm (a) and V-Arm (b). Fig. 1 Fig. 3 Fig. 2 Fig. 4a Fig. 4b 38 implants 3 2017