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What’s Holding You Back from a Digital Implant Workflow?


Newsflash: we’re halfway through 2019. This was the year you were supposed to bring a digital workflow for implant planning into your practice, keeping more procedures in-house and improving your practice’s bottom line. Now that we’ve reached the end of June, it’s time for some honest self-assessment: what’s holding you back from this next phase of growth in your practice?

Incorporating a new digital workflow is like anything else: it’s not only an important investment decision, but also a commitment to growth. Growth requires a leap, where you leave “safe ground” and try something new. This leap is less scary if you have confidence in the devices and systems needed to execute.  

To see what’s really involved for you and your practice, let’s take a closer look at the complete digital workflow for implant planning, as presented by the experts at Planmeca


Setting Up

Step 1: Design the Smile

Many articles about digital workflow have referred in some way to, “It all starts with a scan.” However, Planmeca starts their workflow with a 2D photo for patient education and motivation. The photo is imported into Planmeca Romexis Smile Design software to create a quick simulation of the new smile. That design can be shared with the whole treatment group and exported to the CAD/CAM system for virtual crown designing.

Step 2: Capture the Cone Beam Image

The next step is to use any Planmeca CBCT system to acquire an image of the area of interest. You can learn more about the Planmeca ProMax 3D family of units on the company’s website. 

Planmeca also notes that you can import any DICOM file from other systems to Planmeca Romexis. However, the advantages of using a Planmeca CBCT unit are numerous, beginning with Planmeca Ultra Low-Dose technology and Planmeca CALM.

Planmeca Ultra Low-Dose can be used with all voxel sizes and imaging models, and is ideal for obtaining detailed anatomical information at a very low patient dose. This protocol is based on intelligent 3D algorithms that lower effective patient doses significantly without a statistical reduction in image quality. Clinicians should also understand that not all low dose is the same. For example, you could take a ø5x5cm FOV for a single implant site on a normal resolution setting and by enabling Planmeca Ultra Low Dose, acquire and image with the equivalent radiation dose of a single intraoral periapical and all the clarity you need to treatment plan your case. This helps clinicians adhere to the ALARA (As Low As Reasonably Achievable) principle.

Step 3: Take the Digital Impression

This is when you reach for your digital intraoral scanner to capture a digital impression. Planmeca Emerald may be used, but you can also scan conventional impressions with any Planmeca 3D imaging system, or import any digital model in standard .stl format. Wax-ups can additionally be scanned with a desktop scanner and imported in .stl format. 


Step 4: Virtual Crown Design

This is the point where Planmeca’s software really comes into play. Planmeca PlanCAD Easy software is used to virtually design a crown. The intraoral scan and crown will be immediately available in the Planmeca Romexis Implant Planning software module.

Step 5: Implant Planning

A complete virtual setup for the implant plan can be created when a patient’s CBCT image, digital impression, and crown are combined in Planmeca Romexis software. The user then selects their preferred implant from Planmeca’s comprehensive implant library and finds the optimal position for it with the software’s easy-to-use implant tools.

Dr. Walter Renne, an associate professor at the Medical University of South Carolina, describes his experience with Planmeca software: “Nothing is as simple to use yet so extremely powerful as Planmeca Romexis. You can capture intraoral digital impressions with any open scanner and wax using Planmeca PlanCAD Easy. Simply merge your virtual wax-up with DICOM data and design a custom surgical guide for worry-free restorative-driven implant placement. All in one seamless software."


Step 6: The Implant Guide Design

Planmeca Romexis software allows users to be in full control of designing a surgical guide, from a single implant site to a fully edentulous patient. Additionally, if a tooth is removed prior to surgery, the software can remove that tooth, virtually eliminating the need to rescan the patient. The user can then proceed directly to 3D print the guide with Planmeca Creo C5, or they can export the design in an .stl file format and manufacture it with any other suitable printer.

Step 7: Guide Manufacturing

The guide can be printed using the Planmeca Creo C5 3D printer in under 15 minutes, making same-day implant evaluation and surgery a realistic goal for clinicians. Alternatively, the .stl file can be printed by any other 3D printer that has a suitable resin for surgical guides. Afterwards, the implant can be placed as planned with predictability and success.

Step 8: Final Restorations

After osseointegration of the implant, the Planmeca Emerald intraoral scanner can be used to register the implant position by scanning the scan body. Design the abutment and suprastructure with Planmeca PlanCAD Premium or Planmeca PlanCAD Easy software. The final restoration can be milled with Planmeca PlanMill 30 S, or the .stl files can be sent to the milling center of the user’s choice.

Eight steps: it may seem like a lot, but mindset is important. Unlike executing a restorative procedure, confidence in your digital abilities isn’t in your hands alone. As you see in the workflow described above, technology is here to help, if you know how best to leverage it.

You care about your patients, and you want the ability to ensure predictable outcomes. Manufacturers like Planmeca understand that basic need, and that’s why they design implant planning software for efficiency, integration, and success, delivering results you and your patients expect. 

Download “The Complete Implant Workflow” to learn more about Planmeca’s digital implant solution.  

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