Aim

1
Double scan

• Aim
• Clinical indication
• Manufacturing scan prosthesis
• CT scan protocol
• Double scan registration wizard

2
Aim

• Visualize tooth setup within CT images
• Implant planning can be based on both clinical
  and aesthetic considerations
• Visualize mucosa surface
• Necessary for manufacturing of mucosa-supported
  SurgiGuide

3
Clinical indication

• Fully edentulous cases
• Maxilla
• Mandible

4
Manufacturing scan prosthesis

• Good fitting removable denture
• No air between gingiva and prosthesis
• to avoid
• gt false indication mucosa thickness
• gt malfitting mucosa-supported SurgiGuide
• Prosthesis
• Material acrylic resin
• No radio-opaque teeth
• No metallic parts
• Base plate minimally 2 mm thick

5
Manufacturing scan prosthesis

• Markers
• Radio-opaque material
• (e.g. gutta-percha, Titanium, Cavit)
• Shape spherical
• Dimensions app. 2 mm diameter
• Number 8 (4 -15)
• Good distribution
• Spread over entire prosthesis
• Some close to tooth-gingiva border
• Some close to outer border prosthesis

6
CT scan protocol

• CT-scan of patient
• Patient must wear the scan prosthesis
• Positioning in scanner

7
CT scan protocol

• CT-scan of patient
• Image range

Maxilla
Conventional CT
Cone Beam CT
8
CT scan protocol

• CT-scan of patient
• Image range

Mandible
Conventional CT
Cone Beam CT
9
CT scan protocol

• CT-scan of patient
• Scan parameters

Matrix 512 x 512
Field of View 140 170 mm
Slice thickness 0.5 mm (max. 1.0 mm)
Feed per rotation 1.0 mm
Reconstructed slice increment 0.5 mm (max. 1.0 mm)
Reconstruction algorithm Bone or high resolution
Gantry tilt 0
10
CT scan protocol

• CT-scan of prosthesis
• Positioning in scanner
• Similar as positioned in patients mouth

11
CT scan protocol

• CT-scan of prosthesis
• Fixation of prosthesis in scanner
• Use only radiolucent material
• At least more radiolucent than prosthesis
  itself
• Image range
• Full prosthesis
• Scan parameters
• At least same as for patient scan,
• But higher resolution is allowed

12
Double scan registration wizard

• Import scan of patient
• Scan registration wizard

DICOM images of scan of prosthesis preferably in
separate folder!
13
Double scan registration wizard

• Import scan of patient
• Scan registration wizard