Implant Concierge™ Alternative Dual Scan Protocol

Only used for the Sirona Galileos CBCT Unit

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Galileos CT Scanner by Sirona

 

There are many different scan protocols being used throughout the industry today, which adds a level of confusion and complexity to guided surgery cases. In an effort to simplify and minimize confusion and mistakes, Implant Concierge™ will automatically generate a patient specific “scan protocol” that will provide instructions to ensure the most efficient digital workflow is followed.

For a fully edentulous case and if using a Sirona CBCT unit, the most predictable results occur by following an alternative process to our standard, Dual Scan Protocol.  Due to internal DICOM settings within the Sirona Galileos CBCT unit, this “Alternate Dual Scan Protocol” is recommended.  Once again, the “Alternate Dual Scan Protocol” only needs to be followed if you are using the Sirona CBCT unit for fully edentulous cases.

 

Step 1: Duplicate the patient’s well‐fitting denture with clear acrylic

a. NO radiopaque additives such as barium sulfate or Biocryl-X                 

suremark

Implant Concierge™ sells Suremark Markers in a box of 110 for $40

Step 2:  Attach six to eight 1.0mm X‐ray stickers (1.0mm Suremark stickers )

a. Place 3-4 X-ray stickers on buccal and 3-4 on the lingual at varying axial planes

Step 3: Take a CBCT scan of patient wearing denture WITH X-ray markers

a. Do NOT remove or change X-ray markers from original positions

Step 4: Compress and upload CBCT DICOM file to Implant Concierge™

Step 5: Ship the duplicated denture with X-ray markers to Implant Concierge™

a. Ensure denture is bilaterally stabilized during CBCT scan

 

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Clear acrylic denture with Suremark markers

 

Once Implant Concierge™ receives the duplicated denture with X-ray markers, Implant Concierge™ will scan the denture and merge the file with the Sirona DICOM file previously uploaded. Using this protocol, Implant Concierge™ will create and present the ideal restorative based treatment plan to you via a short web-based virtual surgery allowing you to make final changes. After your approval, Implant Concierge™ will design, print and ship the CAD/CAM surgical guide to you within a few business days. Choose from soft-tissue or bone-borne guides. If you are interested in the standard Dual Scan Protocol, click here. To learn more about this and other protocols, call us at 866-977-2228 or to start your surgical guide case, visit www.implantconcierge.com

 

 

 

Surgery Ready Provisionals Are Now Available!

 

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Surgery Ready Provisionals are Now Available!  

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Implant Concierge Virtual Treatment Plan Coordinator™ provides the digital blue-print to create an accurate CAD/CAM Surgical Guide and Surgery-Ready custom provisional restoration all in one box!  Improve your esthetic results with immediate soft tissue support. Save valuable surgical chair-time by eliminating the tedious process of creating a provisional chair-side or scheduling a second appointment.  Implant Concierge is your Virtual Treatment Plan Coordinator™, creating your surgery ready smile. From one source, with one invoice and no software expertise required. Now that’s worth smiling over!  All Implant Concierge surgery-ready provisionals are milled from shade selected PMMA and bonded to a Ti-Base.

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Please visit our website to start your case now! www.implantconcierge.com or call 866-977-2228.

Implant Concierge Biohorizons Compatible Guided Surgery – Easy Workflow, Great Service & Price!

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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.

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#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.

 

 

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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.

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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.

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Coronal view #7

Coronal view #7:  1.5mm distal of #6 root edge.

  

 

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Sagital #9

 

Sagital view #9:  BioHorizons Ø3.8 x 12mm implant positioned safely in bone envelope and in ideal restorative path of radio opaque tooth.

 

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Coronal view #9

 

Coronal view #9: 1.5mm mesial of #10 root edge.

 

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Sagital #14

 

Sagital #14: Biohorizons Ø5.0 x 7.5mm implant placed supra crestal to strategically avoid sinus floor.

 

 

Protocol sheet

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.

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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

 

 

 

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Implant Success!

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.

 

CADCAM Pilot Only Surgical Guide – Missing Lateral

The Implant Concierge provides different types of surgical guides.  For different reasons, a Pilot only guide is requested by dentists.  Some of those reasons could be due to inter-dental space concerns, instrumentation concerns or due to dentists preferences.  The case below, submitted by periodontist Takanari Miyamoto in Omaha, NE, is a great example of a tight inter-dental space.  This case also illustrates the requirements and ease of use of using Implant Concierge Virtual Treatment Plan coordinator to order, track and plan the ideal case when time is short and patient demands are high!  Please enjoy this case and thank you Dr. Miyamoto for allowing us to use your case to showcase the Implant Concierge.  

Pilot Guide for tight Inter-dental space

Dr. Miyamoto

Takanari Miyamoto,

DDS PhD CAGS MSD PC

Diplomates of the American Board of Periodontics 

La Vista, NE 68128

 

Synopsis

Patient referred for implant consultation to replace missing lateral incisor

Patient Profile

68 year old male with no significant health history with congenital missing tooth number 7.

Doctor quote

“I truly enjoyed the service of Implant Concierge! It took only 5 days from the day I ordered the Implant Concierge guide to the time I received in my office. Guide fits very well and the cost was only $225. It was a wonderful experience. – Takanari Miyamoto, DDS PhD CAGS MSD PC

lo 007[1] Pre OP Photo. Congenitally missing tooth 7

 

 

 

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Sagital view of DENTSPLY 3.5 x 11mm

 

Implant #7 (DENTSPLY AstraTech 3.5 x 11mm) virtually placed by Implant Concierge 3D Case Coordinator and then placement was finalize during brief online meeting with Dr. Miyamoto.  The image is very powerful due to the ability to overlay the patient’s soft tissue onto the CBCT dicom scan.  This allows us to place the implant in the ideal restorative B/L, M/D and vertical position to ensure a beautiful restoration. 

 

 

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Splitting the upright

Splitting the uprights!

Coronal slice with measurements showing the space between the implant edge and the adjacent roots of #8 and #6.  Having the ability to plan with Dr. Miyomoto during an online session, we were able to quickly position the implant as well as determine which type of surgical sleeve we could utilize.  In this case, a Facilitate compatible guide was not an option due to the tight inter-dental space.

 

 

 

Swanson,_Lonnie_model_with_sleeve

Here is another stunning image of the virtual surgery with Dr. Miyomoto.  You can see the DENSPLY Astra 3.5mm x 11 mm implant and the master sleeve in the CAD 3D model.

 

 

 

Implant Concierge CAD/CAM Pilot Surgical Guide in surgery.           surgical guide pic 2

 

 

 

 

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Post Op x-ray showing the precision and accuracy of the 3.3mm x 11mm implant.  Not only did Dr. Miyamoto succesfully split the uprights in a challenging surgical space, but he also maximized the surface to bone ratio with the 11mm implant as it snuggles up to the base of the nasal cavity. 

 

 

 

How did Implant Concierge services make a difference in this case?

This patient wanted to schedule the implant surgery right away. I had a confidence that we can get a guide on time because I knew that IC has their own scanner in San Antonio and they can do overnight shipping. IC guide is simple to use and easy to order. “

Thank you Dr. Miyamoto for this great case and congratulations on a successful surgery!  To learn more about the Implant Concierge and our flat rate prices surgical guides, please visit us at www.implantconcierge.com or call us at 866-977-2228 to schedule a demo!