Chapter 81

Insight: Digital technology has had a profound impact on our lives. Computer aided implant surgery allows for precise restorative driven placement of implants. There are several steps that are needed in order to perform this procedure.

Clinical Consideration: In the figure on the left, one sees images of computer screen and surgeon’s view of computer-aided implant surgery navigation simulated with dry mandible.

There are several steps that need to be completed in order to use computer aided implant placement.

Data acquisition. This involves scanning (e.g., CT scan) with fiducial (artificial) radiographic markers (e.g., stent with markers or intentionally placed pins or screws into jaw) or anatomic (natural) markers such as teeth or bony landmarks. 

Identification. The anatomic or fiducial markers will be identified with a probe tracked by the system. If markers were incorporated into a radiographic stent, the stent will again be placed in the mouth and the markers identified by hand with a probe tracked by the stereovision system.

Registration. After identification of the predetermined markers, the software will indicate the best localization or “match” on the arch between the image data and the patient.

Navigation. Ultimately, the operator will be able to visualize surgical instrument navigation (movement). The drilling instruments will be guided to a target point of impact with a 3D spatial orientation.

Accuracy. Sustained accuracy procedures are critical during surgery and should prove reliability in regard to the system’s overall accuracy. This sustained accuracy procedure will be done through contact of the drill on the handpiece with selected teeth, by visualization of markers, which can be viewed by the stereovision system, or repositioning of the radiomarker stent.

Feedback. Variations from the ideal position can be restricted by the software through inactivation of the drill (stop-and-go action) or by an audible or visual cue.

To get more in-depth information please read Chapter 81