1 Radiological Guide

1/6/2018
Jahliye London Tower

Chouf Lebanon 2014
2016
Private collection Private collection

Property of CLIR Property of CLIR
RADIOLOGICAL TEMPLATE
Implant’s axis insertion A MANDATORY STEP IN
IMPLANTOLOGY
Alexandre Khairallah DDS. HSSD. PGD.DEADMFR.MBAIRD
Post Graduate Diploma in Oral Biology
High Specialized Studies Diploma in Oral Surgery
Post Graduate Diploma in Oral & Maxillo-Facial Imaging
Diplomat of the European Academy of Dento-Maxillo-Facial Radiologist
Member of the Implant Council -BAIRD- British Academy of Implant &
Restorative Dentistry
Partner/Opinion Leader Kavo Dental GmBH - Radiology division
Partner/Opinion Leader Carestream health - dental division
Training Director CBCT program Carestream health – Middle East
International Speaker/ Consultant NEOS implant – England
Executive Editor Smile dental journal
Chef de Service Oral & Maxillo-Facial Imaging Dpt / Dental School – LU
Founder & manager of CLIR "Centre de Lecture et d’Interprétation
Private collection Radiologique”
Property of CLIR
http://clir-3d.blogspot.com
1
1/6/2018
The following articles will be discussed in this Implant’s dimensions

presentation:
1- Types of Implant Surgical Guides in Dentistry:
A Review
Kathleen Manuela
2- Treatment planning of the edentulous maxilla
S. Jivraj
3- Precise and Practical Radiographic Stent
Construction for Cone Beam CT Imaging
Dale A. Miles
4-Simplified Guide for Precise Implant
Placement:A Technical Note
Brent D. Kennedy,
Private collection
Property of CLIR Private collection
Property of CLIR
Implant’s dimensions Implant planning Direction of the osteotomy
Courtesy of Private collection

Private collection W. Richter Property of CLIR
Property of CLIR
Direction of the osteotomy
Private collection Private collection Private collection

Property of CLIR Property of CLIR Property of CLIR
2
1/6/2018
Private collection
Property of CLIR Private collection Private collection
Direction of the osteotomy
L B
Private collection
Property of CLIR Private collection Private collection
Guedel canula Guedel canula
Courtesy of
E. Salloum
3
1/6/2018
Adjacent teeth Adjacent teeth Adjacent teeth



4
1/6/2018
Prosthetic reconstruction Prosthetic reconstruction Implant axis
Private collection
Property of CLIR
Off axis implant position Off axis implant position

Off axis implant position Off axis implant position Off axis implant position

5
1/6/2018
Off axis implant position Off axis implant position

Off axis implant position Angulated

Prostheticabutment
solutions

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Property of CLIR Courtesy of S. GANZ Property of CLIR
6
1/6/2018


Property of CLIR Courtesy of S. GANZ Property of CLIR

Property of CLIR Property of CLIR Courtesy of S. GANZ
7
1/6/2018

Courtesy H, Shreim Private collection

Courtesy of S. GANZ Property of CLIR
Genius prosthetic solutions Genius prosthetic solutions Flapless surgery

8
1/6/2018
Osseointegration
Air integration Air integration Soft tissue integration

Soft tissue integration
Courtesy S. Ganz
Courtesy R. Gamil Private collection Private collection

Air integration 3D imaging 3D imaging & Surgical

Template

9
1/6/2018
3D imaging & Surgical Radiological Template (RT)

restrictive
guide guide

Common Radiological Common Radiological Common Radiological

Template (RT) Template (RT) Template (RT)

Common Radiological Common Radiological Common Radiological

Template (RT) Template (RT) Template (RT)

10
1/6/2018
One point template One point template One point template

One point template Tunnel template
Private collection
Property of CLIR
3D assessment One point/ Two lines template One point/ Two lines template

11
1/6/2018
3D assessment

3D assessment Measurement's assessment Measurement's assessment

3D assessment 3D assessment

12
1/6/2018
Barium sulfate Metallic cylinders template

prosthesis / teeth template
Vivo Tac®

Restrictive template Three points radiological Three points radiological

template template
L B

Three points radiological Anterior implant planning Anterior implant planning

template “Cement retained crown” “Screw retained crown”
Private collection *Misch C. Contemporary Implant Dentistry, 3rd Edition *Misch C. Contemporary Implant Dentistry, 3rd Edition
Property of CLIR *Hayashi et al. Oro-facial Implant Axis in the Anterior Maxilla: Property of CLIR
*Hayashi et al. Oro-facial Implant Axis in the Anterior Maxilla: Property of CLIR
a Pilot Study ; Int J Dent Oral Med 2008, Vol 10 a Pilot Study ; Int J Dent Oral Med 2008, Vol 10
13
1/6/2018
Anterior implant planning Anterior implant planning

“Screw retained crown” “Cement retained crown”

IMPLANT
POSITION
AND
DIMENSIONS
Private collection
Property of CLIR Private collection
Property of CLIR
14
1/6/2018
3D assessment Gutta size error

COMMON
RADIOLOGICAL
TEMPLATE
ERRORS:
DURING
Private collection
Property of CLIR
FABRICATION Private collection
Property of CLIR
Gutta position error 1mm hole

filled
COMMON
with RADIOLOGICAL
gutta TEMPLATE
percha
ERRORS:
DURING CBCT
Private collection
READING
Property of CLIR
Panorex drawing Soft tissue superimposition Soft tissue superimposition

15
1/6/2018
Soft tissue retraction Soft tissue retraction

HIDDEN
ADVANTAGES
OF THE
RADIOLOGICAL
Private collection
Property of CLIR
TEMPLATE
Private collection Khairallah A. A Novel Method for the Measurement of Gingival Tissue: Cone beam computed tomography.Esthet Restor
Property of CLIR Dent 20: 366–374, 2008
Soft tissue and crown height assessments Soft tissue and crown height assessments
CROWN
AND
SOFT TISSUE
HEIGHT
ASSESSMENTS
Soft tissue and crown height assessments Crown height assessments
OSTEOTOMY
AND IMPLANT’S
DIRECTION
ASSESSMENTS

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1/6/2018
Bone
Implant
BAID Anatomy
principle(BA)
direction (ID) BAID
BA(+)principle
/ ID(+)
Radiological
Surgical
Directional
Template
Template BA
Success
ID
BA(-) / ID(+) BA(+) / ID(-) BA(+) / ID(+)
L B

Surgical
Radiological
directional
BA(+) Template
/ ID(+)template
(RG) Surgical directional non
(SDT) restrictive template

17
1/6/2018
Private collection
Property of CLIR
Surgical directional guide Open Non-Restrictive

Surgical Directional Template

BA(-) / ID(+) BA(-) / ID(+) BA(-) / ID(+)
L B
L B

Property of CLIR
63-year-old Male Property of CLIR 63-year-old Male Property of CLIR
18
1/6/2018
BA(-) / ID(+) BA(-) / ID(+) BA(+) / ID(-)
L B
L B

63-year-old Male Property of CLIR 63-year-old Male Property of CLIR Property of CLIR

63-year-old Female Property of CLIR
Correction Surgical Directional Correction Surgical Directional

Guide Template
L B L B

19
1/6/2018
SURGICAL
DIRECTIONAL
TEMPLATE
IN-MOUTH
FIXATION
3D printing software 3D printer 3D printed model
MODEL 3D
PRINTING

Template over 3D printed model
DOUBLE
SCAN
TECHNIQUE
20
1/6/2018
Virtual 3d volume generation Implant planning

Full Surgical Guide Full Surgical Restrictive Guide
Private collection Private collection Invivo 5.5 courtesy Kavo Dental GmBH
Advantages Old implant case

* Facilitate surgeries Old implant case
* Less surgical time
* Less errors in implant’s placement
* Less morbidity
Disadvantages
* Based on X rays, stone and/or 3D
printed models
* Planning and surgical errors
* Slight difference between planned
and final implant positions.
* Cost and difficulty of software
21
1/6/2018
Great people don’t

do different
things, they do
the same things 3D
differently IMAGING
Conclusion
Alexandrekhairallah@hotmail.com
Alexandrekhairallah@Gmail.com
Mobile: +961 3 264332
Masai Mara
Kenia 2014
Private collection
Property of CLIR
22
1/6/2018
Mobile: +961 3 264332
Mobile: +961 3 264332
Phoenicien boat
Tyre
Private collection
Property of CLIR
23
1/6/2018
Private collection
Property of CLIR
Implant planning Full Surgical template

Private collection
Property of CLIR
24
1/6/2018
Gutta size error
Private collection
Property of CLIR
One point/ Two lines template Full Barium sulfate template

Full Barium sulfate template Guide over 3D printed model

25
1/6/2018
26

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1/6/2018

Jahliye London Tower

Private collection Private collection

The following articles will be discussed in this Implant’s dimensions

Implant’s dimensions Implant planning Direction of the osteotomy

Courtesy of Private collection

Direction of the osteotomy

Private collection Private collection Private collection

Direction of the osteotomy

Guedel canula Guedel canula

Adjacent teeth Adjacent teeth Adjacent teeth

Private collection Private collection Private collection

Adjacent teeth Adjacent teeth Adjacent teeth

Private collection Private collection Private collection

Adjacent teeth Adjacent teeth Adjacent teeth

Private collection Private collection Private collection

Prosthetic reconstruction Prosthetic reconstruction Implant axis

Off axis implant position Off axis implant position

Private collection Private collection Private collection

Private collection Private collection Private collection

Off axis implant position Off axis implant position

Private collection Private collection

Off axis implant position Angulated

Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Private collection Private collection Private collection

Genius prosthetic solutions Genius prosthetic solutions Genius prosthetic solutions

Courtesy H, Shreim Private collection

Genius prosthetic solutions Genius prosthetic solutions Flapless surgery

Private collection Private collection

Private collection Private collection Private collection

Soft tissue integration

Courtesy R. Gamil Private collection Private collection

Air integration 3D imaging 3D imaging & Surgical

Private collection Private collection Private collection

3D imaging & Surgical Radiological Template (RT)

Private collection Private collection

Common Radiological Common Radiological Common Radiological

Private collection Private collection Private collection

Common Radiological Common Radiological Common Radiological

Private collection Private collection Private collection

One point template One point template One point template

Private collection Private collection

One point template Tunnel template

Private collection Private collection

Private collection Private collection Private collection

3D assessment Measurement's assessment Measurement's assessment

Private collection Private collection Private collection

Private collection Private collection Private collection

Barium sulfate Metallic cylinders template

Private collection Private collection

Restrictive template Three points radiological Three points radiological

Private collection Private collection

Three points radiological Anterior implant planning Anterior implant planning

Anterior implant planning Anterior implant planning