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Follow Bob: Part 2 in online CE series focuses on surgery, 3-D imaging

September 01, 2014

By Kimber Solana

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It only took about a minute, but the use of 3-D imaging scans and software would help make Robert "Bob" Hartman's full-mouth reconstruction surgery a success.

"The 3-D image was used to prepare the surgical guides for my surgery," Bob said. "The guides tell the doctor where to place my implants."

Along with treatment planning, clinical exam and records, the use of cone beam computed tomography scans and planning software SimPlant was crucial in mapping the course of Bob's treatment and surgery.

The use of 3-D imaging and CBCT scan is among the highlights in the second course in the "Follow Bob" CE online series, which tracks a patient's full-mouth reconstruction procedure from diagnosis to surgery. The Association will upload the second course on ADA CE Online this fall.

Bob getting his head scanned.
3-D display: Clinicians used the Planmeca ProMax 3D Plus to develop a bone reduction and surgical guide for Bob. The use of cone beam computed tomography scans and planning software SimPlant were crucial in mapping the course of Bob's treatment and surgery.
Led by Dr. Joseph Massad, of Tulsa, Oklahoma, and co-treated by Dr. David Little, of San Antonio, Bob had immediate maxillary extracted, bone grafts placed and an immediate denture placed. In the lower arch, the remaining teeth were extracted, alveoplasty performed using a bone reduction guide, and implants were placed using a surgical guide. A lower denture was retrofitted and a screw retained provisional prosthesis was inserted.

The process is expected to take about 18 months, culminating in a three-hour Education in the Round course at ADA 2015 — America's Dental Meeting in Washington, D.C. The first course, which launched in May, focused on Bob's diagnosis.

The second course, coming this fall, centers on his surgery, along with the technology used to guide the operation.

Bob's CBCT scans provided information that helped Drs. Massad and Little fabricate a bone reduction and surgical guide, allowing them to extract all of Bob's teeth and place necessary implants. With the 3-D images, the doctors were able to view Bob's mouth from various angles, study his bone density and see what Bob's final results will look like. Bob's upper jaw was re-scanned after sufficient healing three months later.

Bob viewing scan of his head
Dr. Little: "In using the (CBCT) scan information, we fabricated a soft material surgical guide — a three-dimensional scan that allows us to virtually treatment plan before surgery is performed. This allowed us to see the end before we start by virtually planning the case of predictable results."
"In using this (CBCT scan) information, we fabricated a soft material surgical guide — a three dimensional scan that allows us to virtually treatment plan before surgery is performed," said Dr. Little, a general dentist with extensive training in implant dentistry. "This allowed us to see the end before we start by virtually planning the case of predictable results."

To view the first online course, visit ADACEonline.org and search for the session titled "Treatment of a Failing Dentition with Prosthetic Driven Implant Considerations. A 4 Part Series Part 1: Diagnosis and Prognosis of a Failing Dentition."