CEREC Guide completes Sirona's digital dentistry solution

By Joseph Allbeury

Sirona has delivered the missing link in its digital dentistry solution with the launch of CEREC Guide, a software update to the CEREC platform that allows dentists to mill implant surgical guides in-house on the MC XL milling unit.

"CEREC Guide completes a highly sophisticated, efficient and cost-effective digital solution for delivering accurate and predictable guided surgery," said Morne Cheetham, Director of Sirona Dental Systems in Australia and New Zealand.

"When we began allowing imagery from either our GALILEOS or Orthophos XG3D x-ray systems to be combined with intraoral scans from CEREC, it allowed clinicians to formulate a highly accurate virtual three dimensional model of a patient's hard and soft tissues.

"Within that virtual environment, you can then place implants from any manufacturer appropriate for any situation based on available space, bone quality and other factors. You can then design the restoration to be milled by CEREC at the same time to ensure both the surgical and prosthetic outcomes are complimentary.

"Once you begin to operate at this level, however, it is critical to ensure that the surgical placement of the implant matches the virtual treatment plan. Regardless of the skills and experience of the clinician, the most effective way to ensure that occurs is to use a surgical guide and drilling template."

Mr Cheetham said that up until now, the digital treatment plan needed to be sent to SiCAT in Europe for either ClassicGuides (traditional bottom up plans) or OptiGuide (Prosthetic based top down plans) to be produced. SICAT, a Sirona subsidiary based in Germany, would then ship the surgical guide back with a 5-10 day turnaround.

"With CEREC Guide it is now possible to Scan, Plan and Place implants in a 90-minute appointment," Mr Cheetham said. "Most dentists recognise the value of using surgical guides, but high cost and long delivery times has meant surgical guides are only used in 'difficult' cases. Now, CEREC Guide removes these obstacles by allowing surgical guides to be milled on your CEREC MC XL milling unit, quickly and cost-effectively for all indications."

Using CEREC Guide is a simple procedure. A thermoplastic material is heated up and placed over a plaster model of the dentition. At the same time, a radiopaque reference body is inserted into the material over the implant site. This thermoplastic material is then allowed to harden for approximately five minutes.

The resultant scanning template (stent) that this process creates is positioned in the patient's mouth. A 3D x-ray is then acquired. Sirona's GALAXIS software merges the CBCT data with a CEREC scan, creating the basis for the precise planning of the implant position. The planning data is exported to the CEREC software, which then precisely mills a "drill body" that replaces the reference body in the stent. This converts the scanning template into a surgical guide that is ready for use. Various drill keys (see table) are then available for different drill diameters.

"CEREC Guide is a quick, simple, low-cost and precise procedure tailored to a complete range of indications," Mr Cheetham said. "This innovation has profound implications for treatment planning and when combined with our existing product range, it provides a complete in-house digital dentistry solution.

CEREC Guide will be available to dental technicians via a planned update version of the inLab 4.0 software. Surgical guides will continue to be available through SICAT including ClassicGuide, the ideal solution for complex cases involving lab-produced stone models; and OptiGuide, an industrially produced surgical guide created on the basis of optical impressions acquired on the CEREC system.

CEREC Guide drill keys

Drill keys currently available for: