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Compendium
September 2018
Volume 39, Issue 8

Planmeca Open Platform Puts Dentist in Full Control of Implant Workflow Process

Having the ability to digitally plan and execute guided dental implant surgery is no longer a new development, yet many practitioners are still hesitant to adopt this technology. While some specialists view it as a tool for implant dentistry newcomers, Zachary Evans, DMD, PhD, has another opinion. "For those who truly, fundamentally understand the surgical and prosthetic principles behind implant placement, digital technology can help you execute your vision with the highest degree of accuracy," he submits.

As a board-certified periodontist and Assistant Professor at the Medical University of South Carolina in Charleston, Evans welcomes the advantages that accompany the integration of a digital workflow. "The research is overwhelmingly clear," he says. "Fully-guided implant surgery allows much greater accuracy while decreasing complication rates compared with conventional freehand surgery. These are major benefits for the practitioner and the patient and are game changers in the field of dental implants." The Planmeca Romexis® software and implant module, he adds, "give complete control over the entire implant planning and design process, allowing me to customize everything along the way."

Evans is particularly excited about being able to access 3D printing technology within his practice, which gives him the capability to create his own custom 3D surgical guides to execute his planned cases. This, he suggests, is the strength of using the open-platform Planmeca software. "You have freedom to plan your envisioned restoration, dictate implant position, customize according to your preferred implant system, and create a custom surgical guide based upon that information. Many systems are closed and don't allow this level of flexibility."

Planmeca's Romexis system lets Evans import and superimpose an intraoral scan and crown design with cone-beam computed tomography (CBCT) data, then plan and verify the location of the implant prior to placement using realistic implant and abutment models alongside customized restorative designs. From there, he can create a custom implant guide, which can be fabricated using any appropriate 3D printer.

"Planmeca provides an integrated, comprehensive, start-to-finish, prosthetically driven workflow," Evans states. "I especially appreciate how efficiently I can virtually wax teeth in proper occlusion and define the anticipated restorative margins and emergence for future esthetics and health. This is invaluable when virtually planning implants and was initially intimidating to me as a nonrestorative specialist."

"Likewise, I really like having detailed control over the creation of the surgical guides," he continues. "If I anticipate flapping a case, I can eliminate the flange of the guide. I can change the overall dimensions to make it easier for my assistant to help stabilize the guide while in use or alter it to allow room for a bite block or provide access for irrigation. These are things we didn't even consider with lab-fabricated guides, and they're still not possible with most other digital planning systems."

With the Romexis system, he says, "You are only limited by your imagination."

A practitioner using this system, therefore, does not have to rely on other people or technology to make default decisions, Evans says, as these decisions are personalized to the patient from the dentist. "In addition to being user-friendly for novice users, Romexis helps highly experienced clinicians develop solutions that may not be possible with other systems," he suggests. "We use this tool with our periodontics residents, for both their early basic cases and their advanced cases. It can bring peace of mind and instill confidence in challenging situations."

Referring to the digital workflow in general and Planmeca Romexis software specifically, Evans says: "It's such a powerful tool that once it's in practitioners' hands, it can revolutionize the way they practice implant dentistry. It has certainly changed the way I treat my patients. Even for highly experienced practitioners, it can improve the quality of clinical outcomes. That's the real benefit it brings to both the practitioner and the patient."

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