Navigation Guided Surgery

Wanting to have Dental Implants?

Discover the remarkable advantages of navigation-guided implant surgery how it can help you. From increased precision and safety working around important structures in the jaws, this advanced technology offers improved outcomes and enhanced patient experience. Read on to learn more!

So, you have decided that you want to replace that missing or soon to be lost tooth with a fixed tooth. You realise that the main benefits of a fixed tooth is that it will function similar to your natural teeth and support the remaining teeth just as you’re failing tooth would have done.

You’ve considered the fixed options – there are two:

A bridge which requires support from adjacent teeth as well as cutting of these teeth to allow sufficient thickness to create a strong bridge.

Implant which is self-supporting like a natural tooth. It will help shoulder the considerable forces that you will generate on the teeth.

Now you are thinking about the procedure. From other acquaintances or friends, you have some understanding of what is involved.

It’s a surgical procedure which involves cutting the gum to expose the jaw bone.

Drilling to insert the implant in the bone. A number of x-rays during the procedure to ensure that the implant surgeon is away from important structures as well as the alignment of the implant as was planned. This is all checked by eyeballing and some basic measurements.

‍

Stitches – whatever has been cut needs to be sewed back.  You might need to take some time off work to recover and manage the pain with painkillers.

It’s a considerable investment which is really worth it if it lasts a long time. These teeth have to undergo crushing forces of many 10s of kilograms each time your jaw closes together. You have no control over this. People will often tell you that they have a very soft diet or that they don’t need to chew much. This is not under your control. The forces that you generate are dependent on the jaw muscles. Whilst no one can guarantee how long your investment will last, there are certain concepts which will help the teeth last longer:

1. Placing implants precisely underneath where the teeth will be will ensure that the full force generated is supported by the strongest part of the implant. You might not think that this is important but consider how often these teeth may have to undergo chewing cycles. Over a period of 10 years that is almost 11,000 chewing cycles and with three meals a day this will be over many minutes. If the implants and teeth are positioned in the most optimal position, they will have less stress on them and last much longer with less problems.

2. Designing the teeth so that each component from the tooth to the implant is placed in the optimal position to ensure that there is sufficient thickness of these components to withstand the forces you are about to unleash upon them.

3. Surgical Guides. This led to the development of guided surgery where guides are clipped on to the teeth and allow the implant dentist to drill through the holes.  

‍

This markedly improved the accuracy of the procedures. But they are cumbersome and sometimes uncomfortable for the patient.  This is particularly so when they are needed for implant placement for the back teeth where space is limited. The guides need extra-long drills to be used with them which can be uncomfortable for the patient. They also remove tactile feedback and real-time information of what is actually happening during the procedure. But they are certainly a step -up from freehand implant surgery.

‍

‍

‍

‍‍

‍

‍

‍

‍Navigation guided surgery

But with the advent of Navigation guided surgery over the last couple of years implant placement has almost become a non-event.  

Rather than planning in your mouth we can now plan from a virtual digital representation of your mouth to look at the design of the missing tooth from the perspective of real looking teeth and optimal position to be able to support the biting forces.

To achieve this, we want to recreate/design the missing teeth first and then place the implants underneath these where we can maximise the aesthetics and achieve the optimal load distribution to allow these teeth to achieve a maximum life expectancy.

With conventional implant dentistry this is not always the case. Implants are placed where the bone is and the teeth are then made at a later stage to fit in with this often suboptimal position of the teeth. This not only creates undue stresses on the teeth and implant structures but also has a negative impact on the aesthetics of the teeth. Like any engineering which has to withstand heavy loads over a long time these structures will also have a reduced life expectancy.

‍

Planning the teeth design and position digitally allows us to finesse the design as well as the engineering so that we can ensure the best possible fit of the new teeth with your existing teeth.

Now that we know where the implant needs to be how do we translate this accurately to the Optimal 3D position in the mouth?

As alluded to earlier, historically we used to use surgical guides but now we have the benefit of Navigation guided surgery.  

Navigation guided surgery deploys similar technology to what is used to dock spacecraft on the space station. This results in a myriad of benefits:

1. Improved Accuracy: Navigation systems utilise advanced imaging techniques and computerised planning to guide the placement of dental implants with exceptional precision. This leads to improved accuracy in implant positioning, ensuring optimal alignment and fit within the patient's jawbone. Precise implant placement can result in better long-term aesthetic outcomes and improved functionality.

2. Minimally Invasive Approach: Navigation-guided surgery allows for a minimally invasive approach, as it enables the surgeon to create a smaller or sometimes no incision and use smaller instruments. This results in reduced trauma to the surrounding tissues, decreased postoperative pain, and faster recovery for the patient.

3. Personalised Treatment Planning: The use of navigation technology allows for detailed preoperative planning based on the patient's unique anatomy. The dentist can assess the quantity of the bone, evaluate proximity of nerve and blood vessels and determine the optimal implant size, length, and angulation. This personalized approach enhances the predictability and success of the implant procedure.

4. Real-Time Visualization: During the surgery, the navigation system provides real-time visualisation of the surgical site, allowing the surgeon to track the position of the instruments and implants in relation to the patient's anatomy. This immediate feedback helps ensure precise placement and reduces the risk of errors or complications. This is where this trumps over any other implant treatment modalities.

5. Reduced Risk of Damage: Navigation systems provide guidance to avoid critical anatomical structures, such as nerves, blood vessels, and sinus cavities. By minimising the risk of damage to these structures, the procedure becomes safer and less invasive, reducing the likelihood of complications. This also reduces the risk of the procedures.  

6. Enhanced Long-Term Implant Stability: Accurate implant placement achieved through navigation-guided surgery can result in improved long-term stability of the dental implant. Proper alignment and distribution of forces on the implant help to prevent complications such as implant failure, bone loss, or gum recession.

7. Increased chance of leaving with a fixed temporary tooth if the bone is of good quality. The day that you lose your tooth you get your tooth back!

8. Increased Patient Confidence: The use of advanced navigation technology can instil confidence in patients by demonstrating a higher level of precision and safety. Patients are likely to have a better understanding of the treatment plan and feel more comfortable undergoing the procedure, leading to a more positive overall experience.

‍