The digital workflow has become more of a reality now that a great majority of dental laboratories have updated their equipment and knowledge of software-driven CAD/CAM technologies.7 Another recent catalyst has been the proliferation of desktop optical scanning devices for dental laboratories, followed by the introduction of in-office intraoral optical scanners for the clinician. Optical scanning devices now play a significant role in acquiring improved surface detail such as from a stone cast that can be merged with the data from the CBCT dataset, enhancing the accuracy of the planning software.8
Utilization of a digitized diagnostic wax-up or duplicate of a patient’s denture scanning appliance provides an unparalleled ability to visualize the relationship between the desired tooth and the underlying bone. The virtual implant can then be positioned within the receptor site to fit within the envelope of the desired restoration. It is essential to place a virtual abutment or an abutment “projection” with an appropriate vertical height to visualize the spatial positioning of the abutment as it relates to the tooth to achieve restoratively driven outcomes (Figure 8). Once the implant position has been finalized, a surgical guide can then be fabricated, facilitating proper implant placement (Figure 9). Precise and accurate templates can be fabricated by either CAD/CAM or 3D printing technologies, which are becoming much more affordable for both dental laboratories and clinicians.
Today’s sophisticated CBCT scan devices have become indispensable diagnostic tools when combined with interactive treatment planning software applications. However, many clinicians are still not confident in their abilities to diagnose and plan in 3D. Some also do not have time to learn sophisticated software. Fortunately, clinicians can now feel confident in bringing the world of 3D imaging to their patients through many third-party entities that exist today, including dental laboratories and imaging centers who are equipped with the knowledge and software expertise to guide clinicians through the maze of technology. Currently, it is the synergy and merging of the various digital technologies that have become the focus and catalyst for significant behavioral change, all based on the initial data provided by CBCT imaging.
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