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All-on-4 Dental Implants with Computer Guided Surgery and Digital Smile Design

All-on-4 Dental Implants with Computer Guided Surgery and Digital Smile Design

by Dr. Kamsiah G Haider BDS, MDSc
Prosthodontist , DSD Master and Instructor

 


All-on-4 Dental Implants with Computer Guided Surgery and Digital Smile Design

Another All-on-4 dental implant case with computer guided surgery stent from DSD Lab Madrid, Spain and prosthesis by the OMNI Lab , Perth, Australia. The patient was scanned in our in-house CBCT scanner while he was still having teeth which were going to fail .

With that information given from the discom and STL files the DSD lab constructed the the virtual implants surgery and other components are located within the prosthesis and facial guided as planned on my side .

This case was set up for the use of Nobel Biocare Nobel Active implants which provide maximum stability due to the tapered body design, and crestal bone preservation due to the horizontal “platform shift” of the restorative table. The proprietary NobelBiocare surgical kit was used long with the manufacturer’s guided surgery kit .

The surgery typically involves minimal discomfort for the patient and can be completed in significantly less time than conventional implant surgery.These cases are cost-effective, durable, and aesthetic, which vastly improves the quality of our patients’ lives.

 

All-on-4® using guided surgery

by Dr. Kamsiah G Haider BDS, MDSc

Nov 26, 2017

 

All-on-4® using guided surgery 

 

The All-on-4® treatment concept was developed in the 1990s as a way to best restore the full arches of the upper and lower jaws. The procedure uses only four implants to secure all teeth in place, hence the name “All-on-4.”

CBCT guided implant planning and surgery is a facially driven treatment plan. It first involves planning an ideal dental restoration for a patient; this may be a complete denture or, for a partially edentulous patient, a digital diagnostic wax-up of the planned restorations.

This virtual treatment plan is then sent to a laboratory (in this case the DSD lab in Madrid) for fabrication of an appliance that is used at the time of surgery to accurately place the implants in their planned position(s). Most larger implant manufacturers offer guided surgery-specific instrumentation for flapless implant placement. When desired and indicated, techniques and armamentarium are available for extractions, bone reduction, immediate implant placement, and immediate loading, all of which are commonly used in the All-on-4 protocol.

At surgery, the surgical guide was properly positioned and stabilized using stabilization pins. Implant-specific instrumentation was used to place the four planned implants to full depth and accurate direction using guided-surgery techniques with implant mounts .

Guided surgery and dental CAD/CAM are complementary technologies that can make the surgical and restorative phases of implant therapy more efficient and predictable.

 

Conclusion


The use of CT-guided surgery to perform the All-on-4 procedure is a combination of technologies that is still not very in common practice.  We @drkamsiah prefer the combination  of these two techniques, together with the digital smile design concept to improve the aesthetic outcome as well.
—-drkamsiah

 

Whom Do I Trust to Do my own Porcelain Veneers?

 

My patients often ask me who usually treats my teeth.  Since I was born with a good set of teeth, I hardly see any dentist. However, I had a few mandatory dental treatments as Continue reading “Whom Do I Trust to Do my own Porcelain Veneers?”

MAJALAHWM.COM : Datin Dr. Kamsiah G. Haider Pakar Pergigian Kosmetik & Digital Smile Design

I was created to create a beautiful smile.”

Saya menemui seorang doktor pergigian kosmetik yang tidak boleh duduk diam, beliau tidak berhenti belajar dan mempelajari teknik-teknik terbaru Continue reading “MAJALAHWM.COM : Datin Dr. Kamsiah G. Haider Pakar Pergigian Kosmetik & Digital Smile Design”

DSD Official Course in Malaysia 2018. 

Dr. Kamsiah is one of the official DSD Instructors and Masters who teach the Digital Smile Design courses.

DSD Malaysia official

I would like to share my experience with Malaysian dental surgeons. In my years in practising clinical dentistry I’ve come across so many instances of patients wanting to rush the end product without a reasonable idea of what it will be. I do my best with every case and try to envision what will please dentist and patient.

From simple to complex cases — DSD is the answer

Guessing is a recipe for failure.There’s an old adage I’ve often referred to: ‘there never seems to be time to do things right, but there’s always time to re-do it’.

Now, by incorporating the digital smile design in my clinal routine,. I am able to eliminate guesswork. I can’t emphasis enough about the importance of having a ‘blueprint’ to achieve the desired result of cosmetic treatment.With digital smile design it makes so much sense .

Since attending several lectures , courses and applying the technique in all my aesthetic cases  , I finally became the first to obtain Master in DSD in Malaysia and the  first DSD Instructor in South East Asia .

Recognise the complex case, how to apply in your daily dentistry .

Precision is the hallmark of every professional dentist. The objective must be to achieve a high degree of certainty. This will also enable both the patient and the dentist to know in advance what the final outcome in advance.

When things go awry from lack of planning and from the failure to work out details before starting an actual restoration, it may shake a patient’s faith in their dentist. To some, digital smile design seems time consuming and meticulous especially in treatment planning . However this was my missing link all these years . It is the secret to having a happy patient.

The Digital Smile Design Concept (DSD) seeks to present to the world a new face of Dentistry, more human, emotional and artistic, but also more efficient and precise through digital technology, further enhancing our noble profession in society, because after all there are not many things in this life that are more important than a healthy, natural, confident and beautiful SMILE.

Overview of the course:

Complex cases are not limited to the number of units in the case. They range from single unit cases to full mouth reconstruction cases. Even straight forward cases could be complex cases. To avoid unforeseen patient and dental problems, sound treatment knowledge and treatment planning skills are essential for managing these cases. Recognizing problems beyond the dental scope and expanding your view to the entire patient is especially important for a successful treatment outcome. Participants will have the opportunity to learn how the Digital Smile Design concept helps in their daily dentistry.

Course Objectives:

At the end of the Stage I course (Introduction level), you will be better able to:

  • Learn data collection and recognize the entire view of the patient from the DSD perspective
  • Know what the data , photos , videos collections are necessary to make sound sequential treatment plan
  • Recognize the complex case
  • Recognize your own limitation and determine whether to treat or refer the patient
  • Learn how to manage complex cases

Note:

This course will be followed by two other sessions . Each session will give participants the opportunity to discuss their own complex case treatment plan with the instructor and other participants.

At the end of the Stage II course (Intermediate level), you will be better able to:

  • Recognize wise use of mock provisionals
  • Learn advanced data collection and sequential treatment planning
  • Learn how to manage complex cases
  • Lean how to work with (other) specialists

At the end of the Stage III course (Advanced level), you will be better able to:

  • Understand the role of digital technology for treatment planning
  • Assess the risk of treating advanced complex cases
  • Learn how to manage complex cases
  • Lean how to work with (other) specialists

Teaching Method: Lecture, hands-on  and case discussion

Recommended for: General dentists and specialists