Fabrication of Surgical Template for CT-based Implant Planning

Prosthetic driven implant placement requires a planning procedure, which considers the available bone and the optimal prosthetic position of the crown. In our days more and more CT-based planning procedures are used, especially for very esthetic demanding cases or if immediate restoration is performed.For the CT-based planning we use routinely a wax-up, which is transferred in acrylic resin. Depending on the esthetic demand of reconstruction two type for the reference are used. For the functional rehabilitation, quite often with immediate loading, the prosthetic axis is referenced by a gutta-percha point ISO 100, which is placed in the center of the crown. For the optimal vertical position the length of the gutta-percha point is chosen in the same length like the cone of the esthetic abutment (FRIADENT, Mannheim, Germany). In esthetic demanding cases the crowns are transferred by a BaSO4-doted resin with is then fixed in a transparent resin. This allows the control of the implant position in relation to the contour of the crown in respect with the soft-tissue situation.Depending to the transfer system for surgery different references are necessary. After the CT-scan the template is modified according the surgical transfer system.Implant planning based on the ideal position of the prosthetic cone of the abutment allows determining the ideal position of the implant under prosthetic considerations. The transfer of the planning by CT-based fabricated template (Med3D, Heidelberg, Germany) or CT-based Navigation (Robodent, Berlin, Germany) is demonstrated. Keywords: static navigation, dynamic navigation, implant planning, 3D imaging