Surgical Case Planning

Digital Smile Designing 

We at Indent Dental Laboratory believe what we provide for our patients is more than simple dentistry. We believe we contribute beauty to the world. Creating beautiful, customized smiles and bringing joy to your patients is a calling we take very diligently.

We believe getting to know our patients is the first brushstroke in this creation. Because everyone has unique circumstances, needs, and desires, communication is key. Knowing who your patients are and where they come from is essential in helping them get to where they want to be. The process is a true creative collaboration. For us, excellence is our constant artistic pursuit. Cutting-edge technology and use of the latest techniques in smile design are supplemented by years of training and a true love for our craft. We at Indent Dental Laboratory will strive for nothing less than the mastery of this medium in which we have chosen to create.

Our CS 9300 has been ideal for our dental and maxillofacial practice as it features dual modality panoramic and 3D imaging with exceptional detail and range, which helps perfect all-in-one solution for our practice. Dental 3D printing is a key at Indent laboratory for modern dentistry, as it really helps for customization and treatment planning. It is actually possible to create a 3D model to replace a missing tooth with more accuracy than with traditional methods.

The start of every engineering process begins in the world of CAD. Our Exocad software is an integrated software solution that guarantees the seamless functionality of the digital workflow – from virtual, prosthetic-oriented implant planning to designing surgical guides with our Guide Creator. CAM application (Xtcera – X-Mill 300 and CORiTEC 350i – imes – icore) uses computer software and machinery to facilitate and automate manufacturing processes. CAD focuses on the design of a product or part. How it looks, how it functions. CAM focuses on how to make it. On top f this, intraoral scanners have made it easier to get the bite of the patients within few minutes avoiding gag and discomfort!
We know what we do changes lives. What we do allows your patients to smile with confidence and take pride in themselves reducing their time at the Dental clinic.

Maxillofacial Prosthesis

In simple terms, Maxillofacial Prosthesis are artificial appliances or devices that are used to replace missing facial or oral structures. The purpose of a Maxillofacial Prosthesis is to preserve residual structures, reconstruct function and/or improve esthetics. Like many other dental appliances and prostheses, maxillofacial prostheses are also available in its fixed and removable forms.

Here are a couple of examples of Removable Maxillofacial Prosthesis –

1. Auricular Prostheses

An auricular prosthesis is an artificial substitute for malformed, lost or removed parts of the ear pinna. Many materials have been used to manufacture such kinds of prostheses, but silicone has proved to be the most effective one so far.

2. Ocular Prostheses

An ocular prosthesis is an artificial eye, which is implanted in patients who have lost their eye due to causes such as trauma, surgery or cancer, or in patients with shrunken, damaged eyes, congenital absence of one or both eye/s (Anophthalmus) or unusually small eyes (microphthalmos) which lack visual potential. Cryolite glass is commonly used for the manufacture of ocular prostheses.

“Does it matter who treats me and manufactures my prosthesis?”
In one word – yes.

Picking the right doctor and a reliable laboratory for charting out a treatment plan and executing it to maximum effectiveness is of utmost importance, although the two are often interlinked. Factors such as durability of the prosthesis, avoidance of peri-operative and post-operative complications, frequent treatment analysis and adequate damage control are often directly related to the level of expertise, precision and professionalism of the specialists that are responsible for the patient’s prosthesis and related wellbeing.

The quality and longevity of the prosthesis is of a high value when the right measurements are taken, the impression obtained is accurate, and the materials used in fabrication of the prosthesis are of high quality.

CAD/CAM (Computer-aided Design and Computer-aided Manufacturing) techniques are the techniques of choice when it comes to the manufacture of Maxillofacial Prosthesis. These systems provide consistently accurate measurements of the facial morphology and help in accurate reproduction of the same. A non-contact three-dimensional laser system is generally used for this purpose. These systems are operated by laboratory experts and qualified professionals.

Other Maxillofacial procedures that require Maxillofacial Prosthesis –

Hemi maxillectomy – A procedure where half of the maxilla is removed. The removed bone along with the void of the sinus is replaced by obturators in most cases. These can be of surgical, temporary or definitive type.

Hemi mandibulectomy – It is the surgical removal of one lateral half of the mandible. It is usually treated with implants or bone grafting, depending on patient preference and choosing the best way forward.

Orthognathic Surgery

Orthognathic surgery requires precise evaluation of sometimes complex dentofacial deformities of the craniofacial skeleton. The success of the surgical plan is not only dependent on the accuracy of the skeletal and dental diagnosis of the deformity, but also on the presurgical predictions of the proposed jaw movements. For precise case evaluation, treatment planning and consequent patient satisfaction, every member of our team here at India Dental Laboratory carries our core value of providing the highest quality of service to all those who entrust us with their dental wellbeing.

We have a systematic, precise and intricate approach which helps us provide an end-to-end solution to the patients that require orthognathic surgery –

CBCT Case Planning and 3D Modelling

Dental Cone Beam Tomography [Dental CBCT] is used to perform a complete facial, profile and cephalometric analysis, which includes facial form, transverse dimensions, facial symmetry and the vertical relationship. It also evaluates the position of teeth, bone structures, joints and the airway. This technique helps in estimating the accurate placement of implants, provides 3D orthognathic evaluation, assesses potentially impacted teeth and identifies the nuances of the TMJ complex. These images are sometimes turned into 3D models to assess patients better.

Computer Visualisation of the Final Result

CBCT imaging in tandem with appropriate software and virtual patent-specific models enables the examination of hard and soft craniofacial tissues and their spatial relationships. This is used to generate virtual models and check treatment options, in order to create accurate substitute grafts. In addition, computer visualisation is also used for planning the accurate placement of temporary anchorage devices, if necessary.

Tracings

A key stepping stone in orthognathic treatment planning is cephalometric prediction tracing, also known as the visual treatment objective. Prediction tracing permits the surgeon to visualise this treatment objective, therefore allowing refinement of the original plan and ascertainment that the correct soft tissue profile will be obtained for maximum aesthetic value.

Fabrication of Surgical Splints and Custom Implants

Fabrication of surgical splints and custom implants is the final step in orthognathic case planning. This is done using CBCT image data after virtually planning a patient’s treatment. Splints and implants can also be fabricated using 3D printing techniques.

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Splints, Guides and 3D Models

Splints

Splints are external mechanical devices applied to protect healing structures, maintain
or improve joint range of motion (ROM), substitute for or enhance impaired function, or serve as the basis for attachment of self-help devices. The operative goals for any maxillofacial fracture repair include the application of stable fixation techniques that are minimally invasive and restore occlusion, providing for return to function as soon as possible.

Regardless of their shapes, mechanically speaking, splints operate in one of two basic ways. Most splints applied in clinics use a series of three-point pressures to control or affect joint motion, whereas the other type of splints is called coaptation splints. In dentistry, splints can be used to treat TMJ disorders, occlusal imbalances, bruxism, periodontal ligament proprioception and for use in orthognathic surgery.

There are four types of splints used in dentistry:

1. Permissive
2. Non-permissive
3. Hydrostatic
4. Silicone

Guides

The use of medical imaging and software planning has led to considerable improvement in treatment planning, where surgical guides now play an important role in transferring the pre-mapped plan to placing the implants at their designated positions (angulation and depth). Use of surgical guides is not limited to placing implants in critical anatomical situations, but also for placing implants routinely at ideal positions in the bone, in turn increasing the esthetic and functional advantages of prosthodontic-driven implants. Surgical guides help in guiding osteotomy drills and implant fixtures at the correct position, angulation and depths, and also help in indicating the amount of bone reduction or bone harvesting.

Advantages of Surgical Guides:

1. Decreases manual errors.
2. Minimally invasive procedure, leading to reduced postoperative complications.
3. Increased accuracy and precision of implant placement.
4. The slightest error in implant placement can lead to severe complications. Surgical guides help prevent that and add to the overall safety of the procedure.

3D Models

The 3D modelling technology, also known as additive manufacturing, rapid prototyping or solid-freeform technology, is a recent technological breakthrough which has equipped dentists and surgeons to effectively reproduce or improve preoperative form and function, along with helping them achieve minimal operative and postoperative complications. It has the ability to create complex constructs with high accuracy and precision.

Benefits of 3D Modelling:

1. Increased precision.
2. Reduced surgical time.
3. Provides realistic simulations of surgical procedures.
4. Anatomic models are simple, rapid and inexpensive.