Nicholas Poulos, DDS, Poulos Somers Periodontics & Implantology, Denver, CO
The Implant Concierge™ CAD/CAM surgical guide was great! Guide fit was spot on, the workflow and protocol was simple and surgery was great. I was very pleased with the entire process, service and price of Implant Concierge™. – Nicholas Poulos, D.D.S.
Patient Profile 72 year old female with no significant medical history.
Synopsis Patient was referred for implant consultation to replace tooth numbers 7, 9, and 14. In anticipation that a CBCT scan would be taken at Poulos Somers Periodontics and Implantolgy, the restorative dentist created a patient-specific radiographic prosthesis that was worn during the CBCT scan. The restorative position of the missing teeth was communicated by drilling through the barium sulfate radio opaque teeth, creating the ideal restorative axis and position.
#14 Sagital View
After the CBCT scan was acquired with the patient wearing a radio opaque barium sulfate radiographic prosthesis (scanning appliance), the diagnostic model was digitized and converted to a .stl file by Implant Concierge™ using a 3Shape D700 optical scanner. The digital model was registered to the CBCT DICOM creating a multi-layered file (DICOM + .stl) allowing for accurate soft tissue and hard tissue representation. BioHorizons implants were precisely positioned in #7, #9 and #14 during an online virtual surgery hosted by an Implant Concierge 3D Case Coordinator and Dr. Poulos.
3D rendered image
#14 Sagital View of radio opague tooth with opposing dentition. Channel has been drilled to illustrate ideal restorative position to aid in virtual surgery.
To the right is an image of the digitized diagnostic model that was shipped to Implant Concierge using a 3Shape D700 optical scanner. The .stl file that was created was then registered to the CBCT DICOM, thus aiding in the placement of the ideal restorative position using the hard tissue and soft tissue. This digital .stl file will be the basis for the optimal fit of the CAD/CAM surgical guide.
Sagital view #7
After all of the files were digitized and registered by a 3D Case Coordinator at Implant Concierge, then the initial treatment planning began. Here is a sagital image of a Biohorizons Ø3.8 x 12 mm implant positioned safely in envelope of bone and in the planned ideal restorative path of radio opaque tooth.
Below are a series of other images from the key muli-planar views that only a CBCT can generate. All views, axial, coronal and sagital are utilized during the initial case presentation to ensure the ideal position of the implants.
Coronal view #7
Coronal view #7: 1.5mm distal of #6 root edge.
Sagital view #9: BioHorizons Ø3.8 x 12mm implant positioned safely in bone envelope and in ideal restorative path of radio opaque tooth.
Coronal view #9
Coronal view #9: 1.5mm mesial of #10 root edge.
Sagital #14: Biohorizons Ø5.0 x 7.5mm implant placed supra crestal to strategically avoid sinus floor.
Implant Concierge Surgical Protocol
After the Final VIP meeting took place with a 3D Case Coordinator and Dr. Poulos signed the Authorization Form, a Surgical Protocol sheet was provided. This Sugical Protocol Sheet, utilizing the BioHorizons fully guided surgical kit, provides all of the necessary surgical instructions as well as implant driver stop positions to ensure a precise and proficient surgery.
Implant Concierge CAD/CAM Surgical Guide
Implant Concierge BioHorizons Compatible CAD/CAM guide printed with a Stratasys Objet 3D printer at Implant Concierge™ headquarters in San Antonio, TX
At completion of surgery, Dr. Poulos takes the final post OP x-ray of another successful and efficient guided implant placement of #7 and #9 implants.
Implant Concierge™ would like to thank Dr. Nick Poulos with Poulos Sommers Periodontics and Implantology in Denver, CO, for allowing us to submit this case. In addition, we would like to thank Matt Goff with BioHorizons for his support in the Denver metro market.
Implant Concierge™ is also compatible with the following implant manufacturer guided kits:
- Straumann Guided Kit
- Nobel Clinician Procera Active, Straight and Tapered Guided Kit
- Zimmer Guided Kit
- Implant Direct Guided Kit
- Camlog Guided Surgery
- Biomet 3i Navigator
- Coming Soon: DENTSPLY EV Guided Kit
For more information or to schedule a demo to learn how Implant Concierge™ Virtual Treatment Plan Coordinator™ can make guided surgery affordable and easy for your office, please visit www.implantconcierge.com or call us at (866)977-2228.