By Dr Terry Rose, Smile in Style, Moonee Ponds, VIC
I purchased the Straumann Guided Surgery Kit in early 2011 and have completed 10 implants (four single and one full upper arch with six implants) using the kit. Many lecturers will tell you that guided implant surgery is the way of the future. Now that all the tools are available, it will be interesting to see whether guided implant surgery becomes a new standard of care.
To perform guided implant surgery you need a range of things in place:
• Access to cone beam technology;
• Construction of diagnostic templates to idealise prosthetic/implant positioning;
• Implant planning software or a planning service (eg. 3DDX in the USA);
• Production of surgical guides;
• Guided surgery kit.
Of course, training is a necessary prerequisite for success. I have done a number of Straumann courses and the implant mini-residency course offered by Progressive Orthodontics and Dentistry (POS course) in Sydney.
The Straumann sister products to the guided surgery kit are Codiagnostix (planning software) and Gonyx (surgical guide production). Both are unavailable in Australia and can not be supplied to Australian customers through Europe or the US markets. The Straumann Asian division considers Australia too small a market at this stage to launch and support these products.
POS implant training enabled me to plan my cases and build my own diagnostic guides. Initially, I exported the cone beam multiformatted DICOM files to 3DDX.com in the USA for planning. This followed with referral to Tomatic in Sydney for surgical guide production through Materialise Dental. Recently I purchased Simplant to import cone beam files and do all my planning in-house. The surgical guide production is still done through Materialise Dental.
When using the Straumann, longer drills are needed for the osteotomy so care must be taken with planning when moving posteriorly and if there is inadequate opening. It is also necessary to ensure the guide is stable during the procedure, including use of fixation screws in fully edentulous cases. Drills must be fully engaged in the sleeves before beginning drilling and stopped before removal from the sleeves to avoid damage to the instruments.
What’s good about it
More relaxed, faster surgery. Less likely to need to raise flaps. Increased accuracy in determining implant placement. Fewer rude surprises on post op PA’s. More control!
What’s not so good
More time in planning. Higher costs to patients (surgical guides through Materialise Dental add an extra $1000 to the procedure). Having said this, most patients recognise the value in ideal implant placement and are willing to bear the additional cost. Higher costs in setup with software, guided surgery kit, diagnostic and surgical guides. Further training is also needed.
Where did you get it
From Straumann Australia (second kit sold in Australia).
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