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New York Guided Implants

NobelGuide Surgery Templates

Computerized Dental Implants The field of Implant Dentistry, Oral and Maxillofacial Surgery and other oral surgery disciplines are adapting to digital and virtual imaging at a remarkable rate.

As in our practice, practitioners and individual doctors who have maintained a focus on the Gold Standard of Implant Dentistry (Nobel Biocare implants and procedures) are incorporating the new Cone Beam Catscan technologies and surgical software.

New surgical procedures and protocols have not only created diagnostic and treatment accuracies with unheard of precision..... but also now provide implant or bone preparation opportunities for patients who historically could not be treated.

Guided Implants: The Growth of a New Standard

Cone Beam catscans, despite being a offshoot of the old MRI and CatScans we are all familiar with in the medical world, have redefined what is possible with 3-D imaging sciences.

The I-Cat scanner, the scanning equipment used by Dr. Koeppel, is able to create imaging scans so accurate that patients can now easily see and comprehend, for the first time, the condition of jawbone mass, placement of critical nerve pathways, tissue health in the Sinus Cavity areas and the relative tissue health for any or all treatments under consideration. Read more about 3-D Imaging here.

NobelGuides: Digitally Created Surgical Guides

Icat Cone Beam Accurate Surgery
Click picture to watch video
Most radiographic images that are used today for determining where to place implants are two dimensional. By combining multiple x-rays of a particular implant site, a reasonable estimate of bone height and bone width can be obtained.

In many cases however, absolute bone quality is not determined until the bone is exposed during surgery. This often leads to surprises for the implant surgeon. Taking the gamble of placing an implant device into bone that is marginally adequate width may result in failure or a restoration that cannot be completed properly.

The Marriage of Engineering and Dental Surgery Science

Nobel Biocare has combined the technology advances in 3-D Imaging (catscans) with specialized engineering software (CAD/CAM Processes) to create one of the first ground breaking assistive devices used by implant dentists, oral surgeons, periodontists and reconstructive prosthodontists.

The technical data generated by the I-Cat Cone Beam scans is used to generate a custom milled Surgical Guide (NobelGuide) that defines the configuration and placement of Nobel Biocare implant devices with astounding accuracy.

Achieving Perfection

Perfect Long Island diagnostic placement
Raising the bar of perfect placements
Placements of standard or hybrid implant products using the Guided Implant concept are creating tooth replacement possibilities that didn't exist just a few years ago.

Healthy bone and tissue characteristics are methodically matched to a number of implant designs that creates the best opportunities for rock solid osseointegration that can endure at levels that implants are known for.

The adjacent photo is an real life example showing the "fit" of a planned implant device into a specific section of jawbone. Notice the clarity of bone health at the intended implant site.

Implant patients who have chosen the use of Guided Implant surgery are generally amazed at what they learn about their dental conditions and needs... current and in the future. Diagnostics and treatment planning is now a joint activity between Dr. Koeppel and the patient. They can participate in the selection of implant devices, types, sizes ... and in the interim, understand their specificity.

Unique Surgical Guides

Perfect Long Island diagnostic placement
Perfect Long Island diagnostic placement
NobelGuides: Custom CAD / CAM Milling
Site specific drilling guides are developed for nearly any location on an upper or lower jaw. An implant guide can be developed for a single tooth... all the way to an entire set of new teeth, for edentulous patients.

Say Goodbye to Freehand Implant Placement

Freehand implants, a currently accepted and readily practiced method of implant placement, can be totally eliminated. The "surgery surprise" mentioned above is avoided.

Who is the Best Candidate

A list of common issues or factors is provided here to assist patients in determining if Guided Implant services would be either a beneficial treatment or treatment of choice.

Patients who may derive the most benefit from the use of NobelGuide technologies may have a history of:
  • numerous untreated extractions
  • previous denture wearers
  • patients needing anchored dentures
  • candidates for fixed bridges
  • replacement of failed implants
  • alternative treatment for failed bone grafts
  • patients seeking to avoid bone graft surgery
  • patients who have completed severe gum disease treatments
  • trauma victims
  • congenital jawbone defects
  • aging patients needing renewal or replacement of worn out restorations
  • other compromised bone or resorption issues

The Implant Surgery Event

The entire process of assessment, treatment planning, selection of implant devices and final restoration products is achieved "virtually" before treatment even begins.

Implant patients typically accompany the doctor in reviewing digital representations of their treatment needs. This may include any number of computerized digital images that reflect the shape, density and other characteristics of their jawbone structures.

Patients will determine, with the guidance of the implant surgeon, their best treatment choice for creating the best possible tooth replacement infrastructure. Next, the cosmetic and aesthetic phase is completed, where the final restoration products are selected, based on their choice of types of crowns, abutments, shape, color shading, size, etc.

The technical data is used to fabricate the implant guide(s) and attachment devices, if needed, that are instrumental for treatment.

The actual process of undergoing surgery is comparatively short, since all planning has been completed. Having 4-5-6 implants placed in less than 30 minutes is not unheard of. Understandably, this particular feature of having guided implants is very appealing for most patients.

Need for anesthesia is minimal for many patients ... as is the need for having the jaws kept open for an extended period of time. Post treatment pain or muscular discomfort issues may be non-existent for many patients.

More Questions?

Patients with specific questions about the material on this page or related interests are invited to contact Dr. Koeppel directly with our Ask The Dentist form. Dr. Koeppel will reply to you directly with the information you are seeking.

Call our office at (631)318-0000 to arrange a personal consultation with Dr. Koeppel to learn more about implant guides and how they are used to provide precision tooth replacements. You can also use our on-line Consult Request form to request an appointment.







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New York Reconstructive Dentist
Ira Koeppel, D.D.S.
126 Gnarled Hollow Road
East Setauket Long Island New York NY 11733
Nassau - Suffolk County Spa Dentistry
(631)318-0000