1- The first step is the clinical evaluation. At an initial patient visit, a specific treatment plan is established on the basis of medical and dental history, an oral examination, X-rays, impressions and diagnostic photographs. The Nobel Guide® system is recommended in several cases:
• Immediate teeth replacement of all teeth at the lower or upper jaw
• Difficult dental implant positioning due to poor bone height (no need of bone grafting)
• For some pathologies (e.g. diabetes, heart problems etc…) a minimally invasive flapless surgery is highly recommended in order to avoid risks of infection etc…
2- Once the patient has agreed on that treatment, a radiographic guide |1| and |2| is produced to be used during the CT scan and for the provisory prosthesis to be placed on the implant on the day of surgery.
3- The radiologist performs a specific double CT scan procedure with |5| and without |6| the patient.
4- The data images from the scan are delivered on a CD-ROM. We reformat the digital files using the Nobel Biocare Procera System software. The software converts the CT data into a three-dimensional image |7| of the jaw (and denture). The surgeon places virtually the implants in the best possible way |8| having the flexibility to change the position, quantity, type, length and diameter of the implant. Areas with best bone density can be easily identified and therefore bone graft avoided.
The radiographic guide is reconstructed three-dimensionally |9|. A surgical guide |10| is virtually designed and transmitted via Internet to Sweden where it is fabricated with state-of-the-art technology .
 |
|
|
|
|7| |
|8| |
|9| |
|10| |
5- When the surgical guide is returned to iSi Dental Implant Centre, it is sent to our dental laboratory together with the radiographic guide. Using the surgical and radiographic guides and the models of the jaws, the provisory prosthesis (immediate teeth to be placed on the implants) is fabricated in the laboratory |11| |12|.
6- On the day of surgery |14|, this surgical guide is placed in the patient’s mouth. It will guide the exact implants placement |13|. The surgical procedure requires no incision, no sutures, and therefore minimal post-operative reactions (non bleeding, reduced swelling and pain).
7-After a final radiographic control |15|, the provisory prosthesis is placed. Implants generally take about six months to heal and grow in (osseointegration). Once the implant has anchored witht the jawbone, the final prosthesis (with titanium framework for more rigidity) is placed, and the process is done.
 |
| |15| |
Author: JM BELLAICHE
Update: 10/12/2009 |
|