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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
| cone beam supplement Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 11: Prosthetic implant planning using the Navident software. Fig. 12: Real-time feedback is provided by Navident using a Jaw Tag and Drill Tag during surgery. Fig. 13: The alveolar crest was levelled by a rongeur. Figs. 14–16: Implants are placed exactly as planned. vertically placed and another for a horizontally placed SDI (Figs. 4a & b). In the presented case, the SDI has been placed vertically to achieve the required stability (Fig. 5). The CT marker, containing the fiducial marker used for the registration of the CT scan to the patient, was at- tached to the V-type arm on the fix-plate at one end. At the other end, the assembly was placed over the SDI’s square head and secured to it using a setscrew which was embedded in the aluminium bracket, with this creat- ing a complete “NaviStent” (Fig. 6). The scan prosthesis was then modified to accommo- date the aluminium bracket before it was placed over the maxillary edentulous ridge (Figs. 7 & 8). For accuracy purpose, it is imperative that the scan prosthesis is sta- ble, while at the same time it should not interfere with the NaviStent. CT scan The following CBCT imaging protocol for Navident dy- namic navigation was applied during CT imaging. Before the scanning procedures, both the modified scanning prosthesis and the NaviStent had been placed into the patient’s upper jaw (Figs. 9 & 10). A CT marker was then connected to the NaviStent. A scout view had been acquired prior to the actual scan to verify the presence of the CT marker in the CT scan. In order to allow for accurate registration, at least three corners of the fiducial marker must be present in the scan. In order to maintain a high level of accuracy during navigation, it is mandatory that the slice thick- ness must not exceed a maximum of 0.4 mm. In this case, the slice thickness had been set to 0.3 mm. After- wards, the scan was exported in DICOM format, then imported into Navident. 42 CAD/CAM 1 2018