1. Aim Clinical indication Manufacturing scan prosthesis CT scan protocol Double scan registration wizard Double scan

2. Visualize tooth setup within CT images Implant planning can be based on both clinical and aesthetic considerations Visualize mucosa surface Necessary for manufacturing of mucosa- supported SurgiGuide Aim

3. Fully edentulous cases –Maxilla –Mandible Clinical indication

4. Good fitting removable denture No air between gingiva and prosthesis to avoid => false indication mucosa thickness => malfitting mucosa-supported SurgiGuide Prosthesis –Material: acrylic resin –No radio-opaque teeth –No metallic parts –Base plate minimally 2 mm thick Manufacturing scan prosthesis

5. Markers –Radio-opaque material (e.g. gutta-percha, Titanium, Cavit ®) –Shape: spherical –Dimensions: app. 2 mm diameter –Number: 8 (4 -15) –Good distribution Spread over entire prosthesis Some close to tooth-gingiva border Some close to outer border prosthesis Manufacturing scan prosthesis

6. CT-scan of patient –Patient must wear the scan prosthesis –Positioning in scanner CT scan protocol Conventional CTCone Beam CT

7. CT-scan of patient –Image range CT scan protocol Conventional CTCone Beam CT Maxilla

8. CT-scan of patient –Image range CT scan protocol Conventional CTCone Beam CT Mandible

9. CT-scan of patient –Scan parameters CT scan protocol Matrix512 x 512 Field of View140 – 170 mm Slice thickness0.5 mm (max. 1.0 mm) Feed per rotation1.0 mm Reconstructed slice increment0.5 mm (max. 1.0 mm) Reconstruction algorithmBone or high resolution Gantry tilt0°

10. CT-scan of prosthesis –Positioning in scanner Similar as positioned in patient’s mouth CT scan protocol MaxillaMandible Conventional CTCone Beam CT

11. CT-scan of prosthesis –Fixation of prosthesis in scanner Use only radiolucent material At least more radiolucent than prosthesis itself –Image range Full prosthesis -Scan parameters At least same as for patient scan, But higher resolution is allowed CT scan protocol

12. Import scan of patient Scan registration wizard Double scan registration wizard Adapt box to only include radio-opaque markers! OR DICOM images of scan of prosthesis preferably in separate folder!

13. Import scan of patient Scan registration wizard Double scan registration wizard Possible to change threshold for prosthesis Possible to adapt box to only include prosthesis