Computed tomography examination with X-ray-template is carried out when in the Implant-Assistant® program, it is required to in advance measure the thickness of the gums around the implant installation area, see the position of the future teeth and/or visualize the position of the opposing teeth when the jaws are closed. This is to ensure the implants are best placed in the bones, and Implant-Guide® created with support on the mucosa, teeth, or a combination of these surfaces. Depending on the clinical situation and the possibility of scanning on CBCT or CT scanners, different kinds of X-ray-template are used: MP(marker points) – radiopaque guide with marker points BC(barium contrast) – radiopaque guide with barium sulphate DI(dental impression) – radiopaque guide made of dental impression X-ray-template can be created at the Center of Dental Implantology. Through the order form on the website, you can place an order for the creation of an X-ray-template and call a courier. Duration of creating an X-ray-template – from 3 to 5 working days.
CT scan with MP X-ray-template
Used on any type of CT scanners for dual scanning The MP X-ray-template is used in the following two cases:
- when there is a metal object in the mouth (crowns, stumps, anchor pins, amalgam fillings, braces, etc.);
- when scanning on a CBCT scanner.
Main stages of creating MP X-ray-template
1. The impressions are removed from the upper and lower jaws and the central occlusion is determined. Using the impressions, plaster models are created and installed in the articulator in a proper position. 2. Modelling the guide begins with the creation of a 4-mm-thick wax base. Then, the teeth are modelled from the wax, or the denture teeth are installed on the wax base. 3. The relationship between the future teeth and opposing teeth are checked. 4. The wax composition created is duplicated by a transparent acrylic plastic. 5. A spherical dental drill (diameter 1 mm) is used to make hollows in the plastic guide for radiopaque markers (marker points). 6. Hollow requirements:
- size: about 1 mm
- their position: beyond the dentition level
- number: 5 to 8
7. The hollows are filled with heated gutta percha.
|Variants and features of MP X-ray-template|
Template with separating elements
|1. Separating elements on the X-ray-template allow making a scan with the dentition separated and the guide rigidly fixed. Separating elements (4 pcs.) lean on the teeth and are in contact with the opposing teeth. In this case, teeth with clearly pronounced fissures and cones should not be chosen.|
|2. The foundation of the guide must cover the maximum mucosal surface, even in the absence of a tooth. To eliminate the formation of gap between the teeth, the mucous, and the guide during contact with the opposing teeth, it is recommended to make at least 4 separating elements.|
|3. When scanning, the patient closes his mouth. Opening of the dentition occurs in the separating elements. This ensures that during the CT scan, the guide is correctly positioned, while the occlusal surface of the teeth is visible.|
Template with separating mouthguard
|4. The foundation of the X-ray-template should be prepared from transparent acrylic plastic, with a support on the equators of the remaining teeth. The future teeth are modelled considering the position of the opposing teeth.|
|5. For the guide to be well fixed and the dentition separated, an separating mouthguard. Needs to be created. It is created in a vacuum former made of a 3mm-thick soft plate.|
|6. The marker points are created as described above.|
|7. The X-ray-template is properly fixed to the jaw. An separating mouthguard is fixed on top of the template and the mouth closed.|
|8. The patient’s functional removable denture can be used as the X-ray-template. To achieve this, radiopaque markers are created on the foundation of that denture. There should be no metal clasps in the prosthesis.|
Important conditions for a high-quality scanning:
- Before sending a patient for a CT scan, be sure to check that the X-ray-template is planted correctly in the mouth.
- In order for the scan to get a tight contact between the X-ray-template and the surface of the teeth and the mucous membrane, teach the patient to properly install the guide and wear the separating mouthguard.