Modified Flapless Dental Implant Surgery for Planning Treatment in a Maxilla Including Sinus Lift Augmentation Through Use of Virtual Surgical Planning and a 3-Dimensional Model

Purpose: The concept of prosthetic-driven implantology may be considered a turning point in the history of modem dental implantology. On the basis of this sophisticated approach, the available bone and the optimal prosthetic position of the future restoration are checked before surgical intervention. However, the major drawback of today's prosthodontic discipline is that it is inherently 2-dimensional in nature, which may prevent the appropriate treatment; this problem can be overcome by the 3-dimensional capability of a computer-assisted approach when performed judiciously. It was proposed that this technique has the potential to provide a high level of safety and accuracy in comparison to traditional surgical procedures. Materials and Methods: Using a novel approach, we performed modified flapless implant surgery accompanied by a simultaneous sinus-lifting procedure. The technique used a 3-dimensional life-sized computer-aided design/computer-aided manufacturing (CAD/CAM) model prepared from the computed tomography images for prosthetic/surgical diagnosis and treatment planning. Results: The procedure of implant planning, model surgery, and sinus floor augmentation in this sophisticated flapless surgical approach has the potential to provide substantial benefits for both patients and practitioners. Conclusions: The versatility of the described technique not only allows more accurate implementation of the treatment plan to the patient's mouth but also may offer many additional significant benefits, including the use of custom surgical guides, life-sized bone model manipulation, and surgical rehearsal, all of which are very difficult to achieve with current traditional procedures. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:2291-2298, 2010