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Dr. Jack Krauser Discusses the Latest in Implant Dentistry
Dr. Jack Krauser is a Florida Periodontist and Treasurer of the International Congress of Oral Implantologists, the largest organized body of dentists placing and restoring implants. He is engaged in clinical practice, teaching and research. Dr. Krauser has taken time out of his busy schedule to share some of his views on implant dentistry with the readers of Osseonews.
Osseonews (ON): Dr. Krauser, would you agree that using a CT scan to aid in the treatment planning for determining the most efficacious positioning and angulations of dental implants is becoming the standard of care?
Dr. Krauser: Well we are not quite there yet. Certainly for complex cases where we are dealing with atrophic alveolar ridges, questionable areas of anatomy, and bone of questionable quality, a CT scan is indeed a valuable tool that enables to make the best possible use of what we have to work with.
ON: Specifically, what are you looking for that you cannot find in a panoramic radiograph?
Dr. Krauser: A panoramic radiograph does not provide all available, valuable information. But a CT scan can provide a 3-dimensional representation where we can actually measure the vertical, buccal-lingual, and mesiodistal dimensions of bone accurately. We can also measure the density of the bone. Panoramic radiographs generally do not provide that kind of information.
ON: How do you use that information?
Dr. Krauser: After incorporation of the data into planning software, we can generate a 3-dimensional model of the patient. This can generate a surgical guide/template for precision flapless placement of the dental implants. Our trained laboratory teammates can generate a milled titanium bar and prosthesis that will fit the implants after they have been placed if they use the powerful Procera System software. Using this information and available technology, we can assemble this data and produce a restoration where we can provide a final prosthesis for our patients at the same time as the surgery. This is now known as “teeth in an hour”.
ON: Could you run through your protocol for “teeth in an hour”.
Dr. Krauser: First of all, we want the patient to understand exactly what we intend to do. In order to accomplish this, we use the XCPT patient presentation software program. With this software we can demonstrate to the patient where we are going to place the implants and how we are going to restore them. This can all be accomplished at the initial patient visit using data from a digital image gathered in 2 or 3-dimensional image or xray.
ON: Does the XCPT also increase patient acceptance of the intended treatment plan?
Dr. Krauser: Definitely. And any staff member can be trained in a day to use the program with a patient.
ON: Please describe your placement protocol.
Dr. Krauser: After patient acceptance of our treatment concept, several exacting pre-surgical prosthetic steps are performed. After careful planning in 3 dimensions, we create a computer generated, stereolithographic, surgical guide/template to place the dental implants. The guide enables me to place each implant at the correct site, desired angulations and to the desired depth. These parameters are very important so the prosthesis can be inserted on the implants at the time of placement. This all must be done with precision.
After placing the dental implants, the restorative teammate places the prosthesis. It can be as simple as that. If I place the implants correctly, and the laboratory technician creates the correct framework and prosthesis, the final prosthesis will fit with precision and comfort.
ON: How long does it take you to perform the procedure?
Dr. Krauser: About one hour, from start to finish.
ON: About how often does everything go the way you have planned?
Dr. Krauser: Most of the time we complete the case in an hour and most of the time everything fits perfectly. Our tolerance for implant placement is extremely accurate. Planning in 3-dimensions eliminates complications like perforating through a cortical plate or anatomical structure.
ON: In those rare instances where you need more treatment or adjusting of the prosthesis, what do you do?
Dr. Krauser: We have an operatory equipped with restorative supplies. This is maintained for those times where the restorative dentist needs to do more than simply insert the prosthesis. We move the patient from the surgical suite into this operatory and the restorative dentist adjusts the prosthesis.
ON: How closely do you work with your restoring dentist?
Dr. Krauser: We have to work as a team. We have to work together closely on each case. Teamwork is essential. I meet regularly with my restoring dentists. At times we have functioned as a study club in order to teach each other updates in materials, techniques and treatment solutions available for our patients.
ON: What are some of the benefits of the i-CAT cone beam system (Imaging Sciences) in particular?
Dr. Krauser: This in-office system occupies similar or less space than a conventional panoramic radiograph machine. It can fit a small space, basically in any office. With the i-CAT, you can scan only the area you are interested in which reduces radiation exposure to the patient. In fact, a full scan of both the maxilla and mandible with the i-CAT requires 10% of the radiation the patient would normally receive if you sent the patient out for a Medical CT scan, and takes less than 1 minute to take the scan, and another few minutes to get the data to the CT computer terminal.. In my mind that is a great advantage of the system. Instant data, and instant confidence in presentation.
ON: What is the approximate cost of the i-CAT?
Dr. Krauser: About 150 thousand dollars. A leasing program is also available and seems to pay for itself.
ON: Does Imaging Sciences provide adequate training and do they have a help-desk?
Dr. Krauser: The time required for training is minimal. Installation and staff traing are done in two days. Their phone or on-line internet help-desk is excellent and I am speaking from experience.
July 4, 2006 in Dental Implant News | Permalink
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Comments
Thanks for being cutting edge and taking the time to educate others. Team work is essential in any office procedure and seems to be missing in many offices!! Happy Birthday!!
Posted by: J Mac!! R.D.H. | Jul 5, 2006 2:08:38 PM
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