CAD0110

I 21 case report _ CT-guided implant surgery I CAD/CAM 1_2010 import the DICOM files into the software program, clean up the scatter, treatment plan the implants, and then see the patient for a second consultation to re- view the treatment plan. Because of the significant time and effort required to complete a computerised treatment plan, I generally reserved this process for the more complicated cases or those for which accu- rate implant placement was critical. Most cases were donethe‘old-fashionedway’duringthisperiod. My next revelation came in 2007, when I first saw the GALILEOS cone-beam computed tomography (CBCT)scannerandstartedthinkingaboutincorporat- ing this into my practice. The beauty of it was not the scanner itself, as most CBCT scanners on the market renderagoodimage;itwasthesoftware.GALAXISand GALILEOS Implant were developed with the dentist in mind, as opposed to most other CT viewing and im- plant-planning programmes, which were modified from existing medical CT software. With very little in- struction, I was able to navigate through the images andstartplanningimplantsurgerylikeanexpert. Sirona, the manufacturer of GALILEOS, hit a home run, in my opinion, when they considered the entire work flow in designing the software suite that was included with their machine. With the simple click of atab,thesamesoftwareprogrammeusedforviewing the scan diagnostically could quickly and easily be usedfortreatmentplanningimplants,andthenorder- ingacustomsurgicalguide. OnceIhadbroughtGALILEOSintomyoffice,lifebe- cameeasier.Now,assoonasmypatientwasscanned, using a radiographic template, the images could be broughtuponthemonitor,andthenimplantplanning couldbeginimmediately.Whatpreviouslytookatleast 30minutesofmytimeandtwopatientvisitswasnow possibleinlessthan5minutesinasingleappointment. Asaresult,casesthatIpreviouslyconsideredtobetoo simple to treat using CT-guided surgery techniques were now suitable candidates. Before I knew it, I was utilising this technology for practically every implant case. The only exception was a case in which a patient couldnotwaitthesevenworkingdaysthatitcurrently takes to have the surgical guide manufactured. CT- guided implant surgery has the benefits of increased accuracy of implant placement through a smaller, minimally invasive incision. Another major benefit to theimplantsurgeonisdecreasedsurgicaltime,which allows one to schedule more patients and more pro- cedures in the day. Of course, this is of little benefit if treatment planning becomes very time-intensive. ThebeautyoftheGALILEOSImplant/siCATsystemisin the integration of work flow that makes the implant planningphaserapidandeffortless.Anadditionalplus is improved inventory control. Instead of requiring a variety of implant sizes for a single case, the exact fixturediameterandlengtharepredetermined,soonly asinglefixturehastobeorderedpersite. We have traditionally relied on panoramic radio- graphs and study models to plan our implant place- ment.Surgicalstentshavealwaysbeenusedinimplan- tology to aid in this process. The traditional surgical Fig. 4_GALILEOS treatment planning report demonstrating position of implant in relationship to existing restoration. Fig. 5_Placement of implant through siCAT surgical guide using Facilitate Surgical Guide. Fig. 6_Provisional abutment attached to immediately placed implant. Fig. 7_Provisional crown on implant immediately after placement. Fig. 5 Fig. 6 Fig. 7 Fig. 4