Restoring Function and Esthetics with Navigated Implant Placement

A 68-year-old woman was referred to our office by her general dentist for evaluation of tooth No. 14, which had been previously treated with a crown and showed radiographic evidence of periapical pathology. The patient reported no symptoms, but the tooth was unresponsive to cold testing. Previous records indicated that the patient had attempted root canal treatment on this tooth in the late 1990s, but the procedure was aborted due to heavy calcification.

To further evaluate the condition of the tooth and surrounding bone, a CBCT scan was taken using the DEXIS ORTHOPANTOMOGRAPH™ OP 3D,™ which delivers exceptionally high-resolution 3D images crucial for accurate assessment of bone density, volume, and anatomical structures. This level of detail is essential for precise implant placement and minimizing risks.

The CBCT scan revealed a periapical radiolucency associated with tooth No. 14. This confirmed the diagnosis of necrotic pulp with asymptomatic apical periodontitis, while also revealing heavy calcification within the canal space and an expansive lesion with bone destruction around the roots. These findings, in conjunction with the history of incomplete cracks noted during crown preparation, suggested a deep fracture as the likely etiology. Due to the poor prognosis, extraction and replacement with a dental implant was recommended.

Treatment Planning with Advanced Technology

To ensure optimal outcomes for the patient, a comprehensive treatment plan was developed utilizing a combination of advanced dental technologies. A DEXIS IS 3800W intraoral scanner was used to capture precise digital impressions of the patient’s dentition. This information, along with the CBCT data, was imported into the DTX Studio™ Implant software, enabling accurate 3D implant planning. By integrating all captured data into a single platform, the DTX Studio software streamlines the workflow by eliminating the need to switch between different imaging and planning programs.

Surgical Procedure and Immediate Implant Placement

Following atraumatic extraction of tooth No. 14, an immediate implant was placed using X-Guide dynamic navigation. This technology provided real-time guidance during surgery, ensuring optimal implant position, angulation, and depth. Bone regenerative material was used to augment the extraction socket and promote optimal bone healing. A healing abutment was placed, and the patient was instructed to avoid placing any load on the surgical site for a period of 6 months.

Restorative Phase and Final Outcome

After 6 months of healing, the patient returned for the restorative phase of treatment. A final impression was taken using the DEXIS IS 3800W intraoral scanner, and a custom abutment and crown were fabricated using the NobelProcera implant system. The final restoration was placed, restoring both function and esthetics to the patient’s dentition.

DEXIS Technology Leads to a Winning Outcome

This case highlights the benefits of utilizing advanced dental technologies for accurate diagnosis, planning, and execution of implant treatment. DEXIS IOS and CBCT present a compelling solution for implant planning due to their seamless integration with the very powerful DTX Studio Implant software. It allows for virtual implant placement with various implant systems and sizes directly on the CBCT scan—facilitating optimal implant selection, angulation, and depth for each of my patients’ unique anatomy.

The software also facilitates communication with my patients by providing clear visualizations of the treatment plan, while also streamlining collaboration with labs and specialists through easy sharing of digital files.

Ultimately, the tight integration of high-resolution imaging, implant planning software, and communication tools within the DEXIS platform makes it a powerful and efficient choice for dentists placing and restoring implants. By embracing these technologies, I can provide my patients with the highest level of care and achieve optimal long-term results.