Implants made by X-Guide 3D dynamic navigation

The X-Guide navigation system has been developed for experienced odontologists, to make them capable of executing the implant surgery on a highest-ever accuracy and safety level. During the intervention, the device shows in real-time the dental drill position (angles, depth, and axe-position) and monitors the itinerary by which the implant reaches its expected and required destination. Essentially, it shows the implant position previously planned by the dentist with the help of a software: it shows the right steps of the insertion- how exactly and in which position and depth, by what angles the implant should be inserted in the mouth to reach the required result.

This is why it’s called a GPS-like procedure: we plan where we want to go and the GPS guides us right to the destination. Since the earlier taken digital imprint can be scanned together with the plan, thus, by the time of making the plan, we can already count on the location of the future crown as well. Moreover, the dental technician can prepare, already before the implant procedure, the temporary crown by CAD/CAM technology, which can be inserted right after installing the implant.

In the X-Guide system, we plan the implants based on the tooth CT and when inserting the implant, the software shows the dentist the itinerary to follow during the procedure. Doing so, it provides a real time feed back about the angles, the itinerary, the axe position, and the depth, and minimises the chance of any failure.

• By virtually positioning the implants, aesthetic and functional results are improving
   
• The risk of complications is lower
   
• Adaptable within tight interdental conditions as well (in opposition with the static navigation system)
   
• Easily adaptable for molar teeth also by minor mouth opening position
   
• The implant becomes more comfortable, more accurate and secure, without opening the gingiva – decreasing by this the volume of surgery zone
   
• Decreases the need of bone substitution, for it makes possible a maximal bone exploitation. In case of an upper molar tooth, bone substitution can be avoided, if we can correctly insert it in the adequate zone of sinus.
   
• Makes possible the one-day surgery, for the planning and the operation can be done on the same day.
   
• During the operation, the implantologist in accordance with his experience and expert intuition can modify the preliminary implant position plans, and its respective size.
   
• Adaptable also for other oral surgery interventions, such as: resection

In the past, the implantologist had executed the insertions manually, controlling the process by simple eye inspection. Later occurred the dental surgical guides, which helped the odontologist to insert the implant. However, these dispose of a certain number of disadvantageous qualities, for example, it is not possible to ensure a sufficient cooling effect through these guides. Another difficulty is the loss of eye control and consequently the loss of any chance for modifications during the intervention. Thus, due to anatomic limits, these guides are not always adaptable.

Nowadays, the most up-to-date and secure procedure is the dynamic navigation implant surgery, where we can detect on the screen of our computer the precise axe position of the implant and our manual movements, even meanwhile the dentist’s hands are not locked (like when using the dental surgical guide) This means, that if suddenly an unexpected factor occurs, it is possible to modify the plan and to continue accordingly. Moreover, since we don’t need to put any kind of guide on the implant surgery zone, the indispensable water cooling is also resolved.

The future is undoubtedly the robot surgery, which partly or completely replaces the implantologist’s work. The success of the dynamic navigation implant surgery method is based on the accurate planification by CBCT, with the help of an adequate software.

1. CT: by a special device, we make a tooth CT recording
    
2. We take digital imprints of the patient’s teeth, by 3shape
    
3. We synchronise the tooth CT recording with the digital imprint
    
4. We plan the precise location of the forthcoming crown or bridge (denture)
    
5. Based on the planned crown, we plan the axe of the implant (adjusted to the crown)
    
6. We transfer the X-Guide file from the implant planning software to the X-Guide device
    
7. Implant surgery: in real time, with the guidance of the system, we apply a normal implant-drilling protocol, meanwhile, the dentist on the navigation screen directs and controls the implant insertion procedure.

Advantages:

• using this technology, we can insert the implant in a more idealistic and anatomically more precise position
• it decreases the risk of any kind of complication (nerve, vascular and sinus cavity damage)
• it decreases the volume of surgery intervention (minimal-invasive intervention): it is not always necessary to execute a gingival incision
• it provides a faster recovery
• by the optimal positioning of the implant, the bone substitution at times can be avoided
• we can preliminary plan and prepare the temporary denture

Disadvantages:

• it requires a longer learning period from the dentist
• planifying the implants takes extra time for the dentist
• it is more expensive, because while preparing the CT, a special clip is to be put into the client’s mouth to reach an accurate positioning, furthermore, the device itself is expensive.