[Guided and computer-assisted implant surgery and prosthetic: The continuous digital workflow]

Abstract

Introduction: New continuous digital workflow protocols of guided and computer-assisted implant surgery improve accuracy of implant positioning.

Technical procedure: The design of the future prosthesis is based on the available prosthetic space, gingival height and occlusal relationship with the opposing and adjacent teeth. The implant position and length depend on volume, density and bone quality, gingival height, tooth-implant and implant-implant distances, implant parallelism, axis and type of the future prosthesis. The crown modeled on the software will therefore serve as a guide to the future implant axis and not the reverse. The guide is made by 3D printing. The software determines surgical protocol with the drilling sequences. The unitary or plural prosthesis, modeled on the software and built before surgery, is loaded directly after implant placing, if needed.

Discussion: These protocols allow for a full continuity of the digital workflow. The software provides the surgeon and the dental technician a total freedom for the prosthetic-surgery guide design and the position of the implants. The prosthetic project, occlusal and aesthetic, taking the bony and surgical constraints into account, is optimized. The implant surgery is simplified and becomes less "stressful" for the patient and the surgeon. Guided and computer-assisted surgery with continuous digital workflow is becoming the technique of choice to improve the accuracy and quality of implant rehabilitation.

Keywords: Chirurgie assistée par ordinateur; Chirurgie guidée par l’imagerie; Computer-assisted surgery; Conception d’implant dentaire et de pilier; Dental implant-abutment design; Image-guided surgery; Immediate dental implant loading; Mise en charge immédiate d’implant dentaire.