October 13, 2025 • 23 mins
Detailing the workflow and features of the dental software for implant planning and surgical guide design. The manual covers essential steps such as CT-to-CT and CT-to-mesh alignment of patient data, defining anatomical structures like the mandibular canal and panoramic curve, and the precise placement of model teeth for backward planning. Significant sections are dedicated to the Implant Positioning process, including selecting components and collision detection, and the comprehensive steps for Creating Surgical Guides, from designing the base to merging the final guide mesh. Furthermore, the document outlines technical requirements, including hardware and software specifications, and highlights various Expert Mode features and tools for advanced functionality, all while emphasizing numerous safety warnings for qualified professional use.
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Episode Transcript
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Speaker 1 (00:00):
Welcome to the deep dive. We're here to cut through
the really dense technical stuff and give you the essential
knowledge you need fast.
Speaker 2 (00:07):
That's the goal.
Speaker 1 (00:08):
So our mission today is, well, it's crucial for anyone
getting into digital dentistry. We're doing a deep dive into
the user manual for Exoplan three point.
Speaker 2 (00:17):
One preoperative planning software.
Speaker 1 (00:19):
Yeah, we're basically summarizing this whole guide, zeroing in on
those decision points that you know really impact patient safety
and surgical precision.
Speaker 2 (00:27):
Think of this deep dive as your accelerated path to
get competent with it. We're tracking the entire digital.
Speaker 1 (00:34):
Workflow from loading scans right from.
Speaker 2 (00:36):
The moment you load that scan data all the way
to producing the final surgical guide file, and we'll be
highlighting the clinical implications behind every setting, every.
Speaker 1 (00:45):
Click, and the payoff for mastering this seems pretty clear.
It's all about precision.
Speaker 2 (00:49):
Absolutely.
Speaker 1 (00:50):
This software lets you do highly accurate pre opt planning
using CT or CBCT data. That's the bedrock for guided surgery, right.
Speaker 2 (00:57):
Exactly, that guided process that's what the door to minimally
invasive stuff often flapless procedures.
Speaker 1 (01:04):
Which means better recovery, better patient experience.
Speaker 2 (01:07):
For sure, especially in tricky cases like say full archidentialist patients,
but in the manuals really firm on. The software is
just a tool. You absolutely need that existing high level
clinical expertise in implant dentistry to use it properly.
Speaker 1 (01:23):
Okay, So let's start where it all begins, the data
and the setup. If a dental professional is getting their
workstation ready, what kind of power are we talking about?
Not specific models, but you know capacity.
Speaker 2 (01:35):
You need some serious horsepower basically because you're dealing with
these large, multi gigabyte volume metric data sets.
Speaker 1 (01:41):
Right.
Speaker 2 (01:41):
So the minimum speck calls for a pretty decent quad
core CPU, eight gigs of RAM, and this is key,
a dedicated capable graphics card GPU, yeah, GPU with at
least two gigabytes of its own video RAM. And it
needs to support the modern graphic stuff like OpenGL four. Yeah,
you need that power for manipulating things in real time.
Speaker 1 (01:59):
And what's the recom nation if you want it to
run smoothly?
Speaker 2 (02:02):
Well, aim higher if you can. The recommended specs suggest
a high performance multi core CPU than Core I seven
or rise in seven territory sixteen gigs of faster DDR
four RAM and a b feer GPU.
Speaker 1 (02:15):
Like maybe six gigs of video.
Speaker 2 (02:17):
RAM exactly something with six GB or more of GD
or six memory. It runs on sixty four bit Windows
ten naturally. But the hardware needs come from rendering these
complex three D volumes.
Speaker 1 (02:28):
Efficiently, and a good monitor helps, I imagine.
Speaker 2 (02:30):
Definitely higher resolution like WQHD or even UHD gives you
much better detail for visual inspection. You need to see
what you're doing clearly.
Speaker 1 (02:38):
Okay, let's talk input data. Exitplan uses that volumetric DICOM data,
typically from a CBCT scan of the jaw area. But
there's this one technical speck. The manual really flags it,
get it wrong, and the whole plan is basically useless.
Speaker 2 (02:50):
You're talking about the voxel resolution limit. That's critical. A
voxel is just like a tiny three D pixel in
that volume scan, right, and it's size defined by pixel
spacing and slice thickness. And the DICOM data absolutely must
not be larger than point six millimeters in any direction.
Speaker 1 (03:05):
Zero point six millimeters? Why is that the magic number?
What happens clinically?
Speaker 2 (03:09):
If it's bigger, well think about it. Larger voxels mean
the system is averaging the density information over a bigger
chunk of space.
Speaker 1 (03:16):
Ah, so it smooths things out too much exactly.
Speaker 2 (03:19):
It can completely hide or blur critically small anatomical details,
things like tiny nerve branches, maybe hairline fractures, or subtle
but important differences in bone quality.
Speaker 1 (03:31):
Things you absolutely need to see for safe planning.
Speaker 2 (03:34):
Precisely, if your input data is coarser than that point
six milimeters limit, the software simply cannot guarantee the precision
you need for safe implant placement. The plan might look
okay on screen, but it doesn't truly represent the fine
details of the patient's anatomy.
Speaker 1 (03:50):
Okay, that's a huge warning. And what about identialist patients.
You mentioned the dual scan protocol earlier.
Speaker 2 (03:55):
Right, that's a specific workflow. It involves two separate CT scans.
Speaker 1 (03:58):
Two scans.
Speaker 2 (04:00):
One is the patient's jawn atomy as usual. The second
scan is of their denture or a custom radiographic guide
they wear during the scan. And this prosthesis must have
radio opaque markers embedded in.
Speaker 1 (04:11):
It, little markers that show up clearly on the CT.
Speaker 2 (04:14):
Correct because later the software uses those markers to accurately
align the scan of the denture, which shows the soft
tissue shape with the scan of the patient's bone. It
bridges that gap, got it.
Speaker 1 (04:26):
And for other data like optical scans models.
Speaker 2 (04:30):
Yeah, for surface scans like from an intro oral scanner
or lab scanner, it supports the standard mesh file formats
you'd expect stloff objask ply those are used for aligning
the bone data to the actual teeth or gingiva surface.
Speaker 1 (04:46):
Okay, let's unpack this. So you've got your high resolution
DICOM data loaded. Now you need to visualize it, orient it.
The manual mentions four main display modes. How do those help? Yeah?
Speaker 2 (04:55):
They each give you a different way to sort of
interpret the density information in the scan. Okay, for instance,
there's an X ray mode. It similar, it's a standard
two D X ray view, which can be familiar. Then
you have the solid modes solid. Yeah, they show the
whole volume, but the voxles are colored either just gray
scale based on density or using like natural colors mapped
to different density ranges, maybe showing bone differently from soft tissue.
Speaker 1 (05:15):
Right.
Speaker 2 (05:15):
But the one that's really foundational for a lot of
the next steps is isosurfaces.
Speaker 1 (05:20):
Isosurfaces, how should we think about that one, what's it doing.
Speaker 2 (05:23):
Think of it like generating a three D skin or
a shell that represents a specific density level. Okay, So
if you set the density threshold the isovalue to match
dense cortical bone, the isosurface visualization creates a three D
surface model showing just that bone structure. It connects all
the voxels that match that specific density you chose.
Speaker 1 (05:43):
Ah, I see, and that leads us right into chapter
six defining density references. This sounds like more than just
making the picture look good. It's calibration.
Speaker 2 (05:54):
It's entirely about calibration, absolutely critical. This is where you
tell the software what houndsfield density values correspond to soft tissue, bone.
Speaker 1 (06:02):
And tooth houndsfield units the density scale in CT scans exactly.
Speaker 2 (06:07):
And these threshold definitions are crucial because they determine how
the software segments the different tissues in the volume, and importantly,
how it generates those surface meshes, the isosurfaces we just
talked about, which you'll use later for alignment and for
designing the surgical guide itself.
Speaker 1 (06:22):
And the manual warns if you mess this up.
Speaker 2 (06:26):
Big problems. If you define those density thresholds incorrectly. You could,
for example, make weak bone look denser than it is,
or you might accidentally hide a suboptimal implant position because
it looks like it's in good bone, but it's actually
just within a falsely defined boundary.
Speaker 1 (06:41):
So what's the practical advice here, especially with CBCT data
which might not have perfect houndsfield values.
Speaker 2 (06:48):
Right, with true medical CT data, the houndsfield units are
pretty reliable, but with CBCT they can vary, So the
advice is.
Speaker 1 (06:56):
Be conservative conservative, how err.
Speaker 2 (06:58):
On the side of caution, use a threshold value for
bone that you know represents solid bone. It's better to
have some areas of software tissue potentially included in your
initial bone view, which you can refine later than to
exclude actual bone or misrepresent its density. If the software
gives you that red blue indicator, maybe lean towards having
a bit more red potential collision load density initially if
(07:20):
you're unsure.
Speaker 1 (07:20):
Okay safety first. After calibrating densities, the next step is
spatial orientation using the panoramic curve Chapter seven correct.
Speaker 2 (07:28):
This curve defines the path for generating the panoramic view
and all the cross sectional slices you'll use for detailed planning.
Speaker 1 (07:34):
Does the software do it automatically?
Speaker 2 (07:36):
It tries, It attempts to draw a line along the
crest of the jar ridge in the axial view, but honestly,
manual adjustment is almost always needed, especially if you only
scan part of the head, or if the anatomy.
Speaker 1 (07:48):
Is unusual so you have to double check it.
Speaker 2 (07:50):
Absolutely, you must verify that the position and the shape
of that panoramic curve are correct before you proceed. Any
error here means all your subsequent cross sectional views and measurements,
the ones you use to check distances to nerves or
bone levels, will be wrong.
Speaker 1 (08:06):
Okay, now we get to a really interesting part, high
stakes too. I imagine alignment chapter eight.
Speaker 2 (08:11):
Definitely high stakes. Alignment is non negotiable if you want
to design a surgical guide. This is where you link
the internal bone information from the CT scan to the
actual surface anatomy.
Speaker 1 (08:22):
You're matching the volumetric data to the surface data.
Speaker 2 (08:24):
Precisely, and you generally have two ways to do this.
CT to mesh alignment, where you align the CT data
to an optical scan like an introral scan of the
teethingingiva or CT tow CT alignment. That's the dual scan
protocol I mentioned, where you align the patient's CT scan
to that separate CT scan of their prost pisis with
the markers.
Speaker 1 (08:45):
Let's focus on ct T mesh first. Sounds like a
two step dance, light point alignment, then best fit alignment.
Speaker 2 (08:50):
That's right. The three point alignment is your starting point.
It's manual. You click on three identical, easily identifiable points
on both the CT data surface that isosurface we talk
about and the optical scan mesh maybe CUSP tips or
incisele edges.
Speaker 1 (09:05):
So the potential pitfall here is accuracy.
Speaker 2 (09:08):
Absolutely, this is just a coarse initial alignment. If you
click those three corresponding points inaccurately, even by a little bit,
the next step, the best fit alignment gets a bad
starting position.
Speaker 1 (09:18):
And the best fit is the computer doing the fine tuning.
Speaker 2 (09:21):
Yeah, the software uses your three point placement as a
starting guess and then runs an algorithm to mathematically find
the best possible overlay between the CT surface and the
optical scan mesh. But if the starting gas is way off,
the algorithm might fail, or worse, it might converge on
an incorrect alignment that looks plausible but is actually wrong.
Speaker 1 (09:43):
Okay, I get the need for precision, but what if
the data itself is messy. Say you've got metal artifacts
from fillings throwing off the CT surface or the gingiva,
and the optical scan is mobile and doesn't match the
CT perfectly. How do you stop that noise messing up
the best fit?
Speaker 2 (09:58):
Ah? Good question. That's where you need to use the
more advanced tools to essentially clean up the data before
running best fit. The manual highlights two key techniques.
Speaker 1 (10:07):
Okay.
Speaker 2 (10:07):
First, cropping the CT mash. You can use tools like
the three D surface editor to basically cut away and
discard the noisy or unreliable parts of the CT surface
maps like areas around metal restorations that cause.
Speaker 1 (10:17):
Scatter, So you remove the bad data point exactly.
Speaker 2 (10:20):
Second, marking future regions on the alignment object, usually the
optical scan. This is super important.
Speaker 1 (10:25):
Marking feature regions. What does that do?
Speaker 2 (10:28):
You essentially paint or select the areas on the optical
scan that you trust are stable and accurately captured in
both data sets. Typically these are the teeth, surfaces, and
maybe some areas of firm attached gingiva or bone if.
Speaker 1 (10:41):
Visible and the areas you don't mark.
Speaker 2 (10:43):
The areas you leave unmarked, like mobile GINGEEVA or areas
with known discrepancies are ignored by the best fit algorithm.
It forces the software to focus only on matching the reliable,
stable areas you selected.
Speaker 1 (10:55):
AH smart so you guide the algorithm.
Speaker 2 (10:57):
You guide the algorithm skipping these steps. Cropping and the
feature marking is a common reason why surgical guides end
up not fitting quite right. You might be off by
a millimeters or two, which is huge in implant surgery.
Speaker 1 (11:08):
Makes sense. Now there's a warning about virtual objects. Say
I've already placed a virtual tooth model where I want
the final crown to be. When I align the CT data,
it might shift. Should that virtual tooth stay put It.
Speaker 2 (11:22):
Feels intuitive that it should stay put right, but the
manual actually advises strongly against that. Really, because if you
place that virtual tooth or any annotations or collision objects
like a nerve canal, relative to the original position of
the CT scan, then when you align and therefore move
the CT scan data, those virtual objects need to move with.
Speaker 1 (11:42):
It AH otherwise their relationship to the anatomy changes.
Speaker 2 (11:45):
Exactly if you leave them static while the CT data
shifts underneath during alignment, they'll end up in the wrong
place relative to the newly aligned anatomical data. So the
software usually prompts you transform these objects along with the
CT and the The answer should almost always.
Speaker 1 (12:01):
Be yes, okay, good clarification. Now quickly on the dual
scan the CT too CT alignment, you load the patient
CT and the prosthesis CT. What's the absolute key step
there for making sure that guide will be stable?
Speaker 2 (12:13):
It comes back to that isosurface concept again, but this
time applied to the procesis scan. You need to extract
a mesh surface from the processis CT data, and the
critical part is adjusting the surface threshold that isovalue very precisely.
You need to capture the fitting surface of the prosthesis perfectly,
the part that contacts the patients comes. Why is that
surface so crucial Because that extracted mesh surface becomes the
(12:36):
basis for designing the surgical guide. If that mesh has
holes or rough edges, or doesn't accurately represent how the
denture sits on the ridge.
Speaker 1 (12:45):
The guide designed on top of it won't fit right
either exactly.
Speaker 2 (12:48):
It won't see properly. It might rock or skid during surgery.
That leads to inaccurate drilling, and that's a major patient
safety risk. Getting that processis mesh extraction right, is fundamental
for the dual scan workflow.
Speaker 1 (13:02):
All right, alignment's done hopefully perfectly now before placing implants.
Safety means defining critical structures. Let's compare the rule for
the mandibular canal chapter twelve versus sinus segmentation chapter thirteen.
Speaker 2 (13:15):
They seem different, they are treated differently by the software. Yes,
the mandibular canal is top priority for safety because of
the nerve. Precisely defining that nerve canal, drawing the tube
around it using the cross sectional views is mandatory if
you're planning implants anywhere near it.
Speaker 1 (13:29):
And if you place an implant and it hits that
nerve tube collision detection.
Speaker 2 (13:33):
Yes, the software detects the collision. And here's the key difference.
The system will not let you proceed. It flags the
collision and you must resolve it, usually by moving the implant,
before you can finalize the plan.
Speaker 1 (13:47):
It's a hard stop.
Speaker 2 (13:48):
It's a hard stop. It's designed to prevent you from
even finalizing a plan that carries a high risk of
permanent nerve injury. The manual even gives a hint if
you're unsure about the exact nerve path, make the safety
to two diameter a bit larger just to be safe.
Speaker 1 (14:02):
Okay, a definite guardrail there. Now, contrast that with segmenting
the maxillary sinus, which you need to do for upper
posterior teeth numbers fourteen eighteen or twenty four to twenty eight.
Speaker 2 (14:12):
Right, You segment the sinus cavity and that also creates
a collision object. But if you place an implant and
it slightly enters that segmented sinus space, the software handles
it differently. It will give you a warning, definitely, but
it allows you to continue planning if you choose to.
Speaker 1 (14:27):
So I'll lets you override the warning, yes, but it
requires you to acknowledge that you're proceeding at your own risk.
Speaker 2 (14:33):
And this decision gets documented in the final surgical report.
Speaker 1 (14:37):
Why the difference? Why allow collision with the sinus but
not the.
Speaker 2 (14:40):
Nerve Because clinically, sometimes a minor intentional perforation into the
sinus floor is part of the plan, maybe for a
sinus lift procedure or specific implant placement techniques. Uhh okay,
So the software flags the potential issue, but ultimately defers
to the clinician's judgment, making sure the decision is documented.
(15:03):
It highlights your responsibility.
Speaker 1 (15:05):
Understood, so structures define. Now we get to the ideal
planning approach restoration driven or backward planning Chapters fourteen and fifteen.
Speaker 2 (15:13):
Yes, this is about planning the implant position based on
where the final tooth needs to be. You start by
placing virtual library teeth.
Speaker 1 (15:20):
Just dropping a tooth onto the model.
Speaker 2 (15:21):
You can start that way, yeah, place it using contact
points with neighbors, or just position it on the gendiva.
But then the advanced mode gives you some really powerful
tools like instant anatomic morphing. This is really neat.
Speaker 1 (15:32):
What does it do.
Speaker 2 (15:33):
The software can automatically adjust the shape of your virtual
library tooth. It can cut away areas where it intersects
with the opposing teeth the antagonist oh to ensure it
fits the bite exactly, or it can adapt the tooth
shape to create proper contact areas with the opposing teeth.
It helps ensure that wherever you place the implant, the
final restoration will actually function correctly in the patient's bite.
(15:56):
You can even use a slider to simulate natural tooth
where or abrasion.
Speaker 1 (16:01):
So you're designing the tooth first, then planning the implant
to support it.
Speaker 2 (16:04):
That's the essence of backward planning. Yes, prosthetically driven implant placement.
Speaker 1 (16:08):
Okay, tooth position is planned, now finally placing the implant itself.
Chapter sixteen. There's a key safety setting here.
Speaker 2 (16:17):
The safety distance absolutely fundamental. This setting defines a virtual
buffer zone or keepout zone, all around the implant.
Speaker 1 (16:24):
Body, like a protective bubble.
Speaker 2 (16:26):
Sort of. Yeah, the default value is adjustable, but again
the manual issues a strong warning you should only use
a safety distance below one point five millimeters in really
exceptional clinically justified situations.
Speaker 1 (16:37):
One point five millimeters minimum generally generally yes.
Speaker 2 (16:41):
And another important point, the minimum distance maintained between two
adjacent implants is automatically set to double whatever safety distance
you've defined double why to ensure their individual safety zones
don't overlap. If your safety distance is two point zero millimeter,
the minimum center to center distance between two implants will
be kept at four point zero minimeter. It preserves that
(17:03):
buffer around each one.
Speaker 1 (17:05):
Makes sense. How do you visually check that everything is
safe while you're positioning the implant. Are there special views?
Speaker 2 (17:10):
Yes, you heavily rely on the secondary views. There's the
implant crossview, which shows you two cross sections perpendicular to
the implant.
Speaker 1 (17:18):
Okay.
Speaker 2 (17:18):
You can rotate this view around the implant's long axis,
letting you inspect the surrounding anatomy, like how close you
are to the nerve tube or the facial bone plate
or the sinus floor from all angles. And the other
view the implant axial view. This one lets you scroll
up and down along the length of the implant, like
looking straight down the drill hole. It's great for checking
bone quality along the implant path and confirming you have
(17:41):
good purchase in the bone, especially near the APEX hashtag
taghtag V. Surgical Guide Creation and finalization.
Speaker 1 (17:48):
Okay, planning's done, safety checks past the final output we're
aiming for. Is that STL file for printing the surgical
guide itself Chapter eighteen. This sounds like it shifts focus
a bit towards manufacturing constraints.
Speaker 2 (18:01):
It absolutely does. Designing the guide involves parameters that are
dictated less by the patient's anatomy and more by how
you're going to make the guide Specifically, your three D
printer and the material.
Speaker 1 (18:11):
You're using right, like the sleeve mounts critical step Chapter
eighteen point.
Speaker 2 (18:15):
Five very critical. When you design the holes for the
metal guide sleeves, there are parameters like minimum based thickness.
This controls how thick the guide material is beneath the sleeve.
Speaker 1 (18:25):
Flange, and if that's too thin, the guide.
Speaker 2 (18:28):
Could flex under drilling pressure, leading to inaccuracy, or it
might even fracture during the surgery. Not good. This thickness
needs to be appropriate for the strength of your chosen
print material.
Speaker 1 (18:39):
Okay, and the other big one seems to be radial
sleeve offset that sounds like the gap around the sleeve exactly.
Speaker 2 (18:46):
It's the tiny space designed between the outer wall of
the metal sleeve and the inner wall of the hole
printed in the guide. This offset accounts for printing tolerances
and ensures the sleeve fits correctly.
Speaker 1 (18:57):
And getting this offset wrong is bad.
Speaker 2 (19:00):
Very bad in either direction. If the offset is too small,
the hole is too tight and you physically won't be
able to insert the metal sleeve into the printed guide,
the guide is useless. If the asset is too large
the hole is too loose, the sleeve will wobble or spin.
That means the drill isn't stable. It can skid deviate,
completely negating the accuracy you plan for. This can lead
(19:22):
to damaging adjacent teeth or nerves.
Speaker 1 (19:25):
And this offset value isn't universal.
Speaker 2 (19:27):
Not at all. It's one hundred percent dependent on your
specific printer, the resin or material you're using, and even
your post processing methods. You usually need to calibrate and
determine the optimal offset for your particular manufacturing workflow.
Speaker 1 (19:42):
Wow, okay, manufacturing matters. What about the guide bottom chapter
eighteen point six. Setting insertion direction?
Speaker 2 (19:49):
Yeah, this involves defining how the guide will set under
the teeth or tissue. You set an insertion path, and crucially,
you digitally block out undercuts.
Speaker 1 (19:58):
Undercuts like on the teeth.
Speaker 2 (20:00):
Exactly areas below the height of contour on the teeth
or rich. If you don't account for these and block
them out digitally, the physical guide will get stuck or
won't seat fully.
Speaker 1 (20:08):
It'll rock or require force.
Speaker 2 (20:10):
Right leading to pain, trauma, or just an inaccurate fit,
which again compromises the whole point of guided surgery.
Speaker 1 (20:16):
So once all these parts, the main guide body, the sleeve,
holes maybe holes for anchor pins if needed, are designed,
they get merged.
Speaker 2 (20:22):
Yes, the software merges all the design components into one
single STL mesh file. That's what you send to the
three D printer or the LAP.
Speaker 1 (20:30):
And what are the final outputs you absolutely need? Besides
the STL.
Speaker 2 (20:34):
You get the merged guide STL file definitely, and alongside
it you get the comprehensive surgical report. This is vital.
Speaker 1 (20:41):
What's in the report everything.
Speaker 2 (20:42):
Details about the implants used, the dimensions, the safety distances
you said, the specific sleeve and drill kit information for
the chosen system. And importantly, it documents any of those
safety decisions you made, like proceeding despite a sinus collision warning.
Speaker 1 (20:58):
And the final warning about.
Speaker 2 (20:59):
This rep the absolute final check. The manual stresses that
the surgeon must review and validate this surgical report clinically
before starting the surgery, and critically, do not modify the
STL file or any other manufacturing files after they've been
generated by the validated plan. Any modification breaks the link
to the verified plan.
Speaker 1 (21:19):
Got it? One last thing. The software has two ways
of working, Wizard versus expert Yeah.
Speaker 2 (21:24):
Quick ditinction. Wizard mode is like having the software hold
your hand. It guides you through the planning steps in
a fixed logical chronological order, great for learning or for
straightforward cases and expert mode. Expert mode gives you freedom.
It unlocks the full toolbox. You can jump between different
planning steps freely using toolbars or menus. This lets you
do more advanced things like digitally extracting a tooth before planning,
(21:47):
using the three D surface editor for detailed mesh modifications,
or revisiting and tweaking alignment steps without starting over. It's
for the power user who knows the workflow inside out.
Hashtag tag t hashtag my four conclusion and takeaway.
Speaker 1 (22:01):
Okay, so after this deep dive, it's crystal clear. Digital
implant planning with software like Exoplan it's not magic. It's
not a push button thing, not at all.
Speaker 2 (22:10):
It's a very systematic process, heavily reliant on risk management.
Speaker 1 (22:14):
Success really seems to hinge on getting that initial data right,
the scan quality, the vauxel size.
Speaker 2 (22:19):
Absolutely, and then rigorously validating things like density settings and
crucially that alignment.
Speaker 1 (22:25):
Step right the alignment seems key, and then.
Speaker 2 (22:27):
Following all the safety checks marking the nerve, segmenting the sinus,
respecting collision warnings before you even think about generating that
final guide file.
Speaker 1 (22:35):
Precision and patient safety are completely intertwined here.
Speaker 2 (22:38):
They are one of the same. In this context. The
software gives you incredible tools and safety nets, but ultimately
the clinician is responsible for ensuring accuracy every step of
the way, especially as we saw with alignment and those
manufacturing specific settings for the guide itself.
Speaker 1 (22:53):
Okay, so for our final thought, our review question for
everyone listening, let's focus it right on that high risk
area we kept coming back to. Getting the alignment spot
on makes.
Speaker 2 (23:03):
Sense, right, So here's the question. What three critical manual
interventions must you, the user successfully manage within the Exoplan
software during either the CT to mesh or the CT
tow CT alignment workflows. Getting these three things right is
essential to ensure the final surgical guide accurately reflects the
patient's true anatomy, which is paramount for preventing patient harm
(23:26):
during the actual surgery.
Speaker 1 (23:27):
Think about calibrating the initial surface, the manual clicking part,
and how you refine the data the computer uses. If
you can nail those three elements derived from the manual's warnings,
you're setting yourself up for a much safer and more
predictable guided surgery, well said, thank you for taking this
deep dive with us today.
Speaker 2 (23:44):
Plan wisely everyone, and be well.
Welcome to the deep dive. We're here to cut through
the really dense technical stuff and give you the essential
knowledge you need fast.
Speaker 2 (00:07):
That's the goal.
Speaker 1 (00:08):
So our mission today is, well, it's crucial for anyone
getting into digital dentistry. We're doing a deep dive into
the user manual for Exoplan three point.
Speaker 2 (00:17):
One preoperative planning software.
Speaker 1 (00:19):
Yeah, we're basically summarizing this whole guide, zeroing in on
those decision points that you know really impact patient safety
and surgical precision.
Speaker 2 (00:27):
Think of this deep dive as your accelerated path to
get competent with it. We're tracking the entire digital.
Speaker 1 (00:34):
Workflow from loading scans right from.
Speaker 2 (00:36):
The moment you load that scan data all the way
to producing the final surgical guide file, and we'll be
highlighting the clinical implications behind every setting, every.
Speaker 1 (00:45):
Click, and the payoff for mastering this seems pretty clear.
It's all about precision.
Speaker 2 (00:49):
Absolutely.
Speaker 1 (00:50):
This software lets you do highly accurate pre opt planning
using CT or CBCT data. That's the bedrock for guided surgery, right.
Speaker 2 (00:57):
Exactly, that guided process that's what the door to minimally
invasive stuff often flapless procedures.
Speaker 1 (01:04):
Which means better recovery, better patient experience.
Speaker 2 (01:07):
For sure, especially in tricky cases like say full archidentialist patients,
but in the manuals really firm on. The software is
just a tool. You absolutely need that existing high level
clinical expertise in implant dentistry to use it properly.
Speaker 1 (01:23):
Okay, So let's start where it all begins, the data
and the setup. If a dental professional is getting their
workstation ready, what kind of power are we talking about?
Not specific models, but you know capacity.
Speaker 2 (01:35):
You need some serious horsepower basically because you're dealing with
these large, multi gigabyte volume metric data sets.
Speaker 1 (01:41):
Right.
Speaker 2 (01:41):
So the minimum speck calls for a pretty decent quad
core CPU, eight gigs of RAM, and this is key,
a dedicated capable graphics card GPU, yeah, GPU with at
least two gigabytes of its own video RAM. And it
needs to support the modern graphic stuff like OpenGL four. Yeah,
you need that power for manipulating things in real time.
Speaker 1 (01:59):
And what's the recom nation if you want it to
run smoothly?
Speaker 2 (02:02):
Well, aim higher if you can. The recommended specs suggest
a high performance multi core CPU than Core I seven
or rise in seven territory sixteen gigs of faster DDR
four RAM and a b feer GPU.
Speaker 1 (02:15):
Like maybe six gigs of video.
Speaker 2 (02:17):
RAM exactly something with six GB or more of GD
or six memory. It runs on sixty four bit Windows
ten naturally. But the hardware needs come from rendering these
complex three D volumes.
Speaker 1 (02:28):
Efficiently, and a good monitor helps, I imagine.
Speaker 2 (02:30):
Definitely higher resolution like WQHD or even UHD gives you
much better detail for visual inspection. You need to see
what you're doing clearly.
Speaker 1 (02:38):
Okay, let's talk input data. Exitplan uses that volumetric DICOM data,
typically from a CBCT scan of the jaw area. But
there's this one technical speck. The manual really flags it,
get it wrong, and the whole plan is basically useless.
Speaker 2 (02:50):
You're talking about the voxel resolution limit. That's critical. A
voxel is just like a tiny three D pixel in
that volume scan, right, and it's size defined by pixel
spacing and slice thickness. And the DICOM data absolutely must
not be larger than point six millimeters in any direction.
Speaker 1 (03:05):
Zero point six millimeters? Why is that the magic number?
What happens clinically?
Speaker 2 (03:09):
If it's bigger, well think about it. Larger voxels mean
the system is averaging the density information over a bigger
chunk of space.
Speaker 1 (03:16):
Ah, so it smooths things out too much exactly.
Speaker 2 (03:19):
It can completely hide or blur critically small anatomical details,
things like tiny nerve branches, maybe hairline fractures, or subtle
but important differences in bone quality.
Speaker 1 (03:31):
Things you absolutely need to see for safe planning.
Speaker 2 (03:34):
Precisely, if your input data is coarser than that point
six milimeters limit, the software simply cannot guarantee the precision
you need for safe implant placement. The plan might look
okay on screen, but it doesn't truly represent the fine
details of the patient's anatomy.
Speaker 1 (03:50):
Okay, that's a huge warning. And what about identialist patients.
You mentioned the dual scan protocol earlier.
Speaker 2 (03:55):
Right, that's a specific workflow. It involves two separate CT scans.
Speaker 1 (03:58):
Two scans.
Speaker 2 (04:00):
One is the patient's jawn atomy as usual. The second
scan is of their denture or a custom radiographic guide
they wear during the scan. And this prosthesis must have
radio opaque markers embedded in.
Speaker 1 (04:11):
It, little markers that show up clearly on the CT.
Speaker 2 (04:14):
Correct because later the software uses those markers to accurately
align the scan of the denture, which shows the soft
tissue shape with the scan of the patient's bone. It
bridges that gap, got it.
Speaker 1 (04:26):
And for other data like optical scans models.
Speaker 2 (04:30):
Yeah, for surface scans like from an intro oral scanner
or lab scanner, it supports the standard mesh file formats
you'd expect stloff objask ply those are used for aligning
the bone data to the actual teeth or gingiva surface.
Speaker 1 (04:46):
Okay, let's unpack this. So you've got your high resolution
DICOM data loaded. Now you need to visualize it, orient it.
The manual mentions four main display modes. How do those help? Yeah?
Speaker 2 (04:55):
They each give you a different way to sort of
interpret the density information in the scan. Okay, for instance,
there's an X ray mode. It similar, it's a standard
two D X ray view, which can be familiar. Then
you have the solid modes solid. Yeah, they show the
whole volume, but the voxles are colored either just gray
scale based on density or using like natural colors mapped
to different density ranges, maybe showing bone differently from soft tissue.
Speaker 1 (05:15):
Right.
Speaker 2 (05:15):
But the one that's really foundational for a lot of
the next steps is isosurfaces.
Speaker 1 (05:20):
Isosurfaces, how should we think about that one, what's it doing.
Speaker 2 (05:23):
Think of it like generating a three D skin or
a shell that represents a specific density level. Okay, So
if you set the density threshold the isovalue to match
dense cortical bone, the isosurface visualization creates a three D
surface model showing just that bone structure. It connects all
the voxels that match that specific density you chose.
Speaker 1 (05:43):
Ah, I see, and that leads us right into chapter
six defining density references. This sounds like more than just
making the picture look good. It's calibration.
Speaker 2 (05:54):
It's entirely about calibration, absolutely critical. This is where you
tell the software what houndsfield density values correspond to soft tissue, bone.
Speaker 1 (06:02):
And tooth houndsfield units the density scale in CT scans exactly.
Speaker 2 (06:07):
And these threshold definitions are crucial because they determine how
the software segments the different tissues in the volume, and importantly,
how it generates those surface meshes, the isosurfaces we just
talked about, which you'll use later for alignment and for
designing the surgical guide itself.
Speaker 1 (06:22):
And the manual warns if you mess this up.
Speaker 2 (06:26):
Big problems. If you define those density thresholds incorrectly. You could,
for example, make weak bone look denser than it is,
or you might accidentally hide a suboptimal implant position because
it looks like it's in good bone, but it's actually
just within a falsely defined boundary.
Speaker 1 (06:41):
So what's the practical advice here, especially with CBCT data
which might not have perfect houndsfield values.
Speaker 2 (06:48):
Right, with true medical CT data, the houndsfield units are
pretty reliable, but with CBCT they can vary, So the
advice is.
Speaker 1 (06:56):
Be conservative conservative, how err.
Speaker 2 (06:58):
On the side of caution, use a threshold value for
bone that you know represents solid bone. It's better to
have some areas of software tissue potentially included in your
initial bone view, which you can refine later than to
exclude actual bone or misrepresent its density. If the software
gives you that red blue indicator, maybe lean towards having
a bit more red potential collision load density initially if
(07:20):
you're unsure.
Speaker 1 (07:20):
Okay safety first. After calibrating densities, the next step is
spatial orientation using the panoramic curve Chapter seven correct.
Speaker 2 (07:28):
This curve defines the path for generating the panoramic view
and all the cross sectional slices you'll use for detailed planning.
Speaker 1 (07:34):
Does the software do it automatically?
Speaker 2 (07:36):
It tries, It attempts to draw a line along the
crest of the jar ridge in the axial view, but honestly,
manual adjustment is almost always needed, especially if you only
scan part of the head, or if the anatomy.
Speaker 1 (07:48):
Is unusual so you have to double check it.
Speaker 2 (07:50):
Absolutely, you must verify that the position and the shape
of that panoramic curve are correct before you proceed. Any
error here means all your subsequent cross sectional views and measurements,
the ones you use to check distances to nerves or
bone levels, will be wrong.
Speaker 1 (08:06):
Okay, now we get to a really interesting part, high
stakes too. I imagine alignment chapter eight.
Speaker 2 (08:11):
Definitely high stakes. Alignment is non negotiable if you want
to design a surgical guide. This is where you link
the internal bone information from the CT scan to the
actual surface anatomy.
Speaker 1 (08:22):
You're matching the volumetric data to the surface data.
Speaker 2 (08:24):
Precisely, and you generally have two ways to do this.
CT to mesh alignment, where you align the CT data
to an optical scan like an introral scan of the
teethingingiva or CT tow CT alignment. That's the dual scan
protocol I mentioned, where you align the patient's CT scan
to that separate CT scan of their prost pisis with
the markers.
Speaker 1 (08:45):
Let's focus on ct T mesh first. Sounds like a
two step dance, light point alignment, then best fit alignment.
Speaker 2 (08:50):
That's right. The three point alignment is your starting point.
It's manual. You click on three identical, easily identifiable points
on both the CT data surface that isosurface we talk
about and the optical scan mesh maybe CUSP tips or
incisele edges.
Speaker 1 (09:05):
So the potential pitfall here is accuracy.
Speaker 2 (09:08):
Absolutely, this is just a coarse initial alignment. If you
click those three corresponding points inaccurately, even by a little bit,
the next step, the best fit alignment gets a bad
starting position.
Speaker 1 (09:18):
And the best fit is the computer doing the fine tuning.
Speaker 2 (09:21):
Yeah, the software uses your three point placement as a
starting guess and then runs an algorithm to mathematically find
the best possible overlay between the CT surface and the
optical scan mesh. But if the starting gas is way off,
the algorithm might fail, or worse, it might converge on
an incorrect alignment that looks plausible but is actually wrong.
Speaker 1 (09:43):
Okay, I get the need for precision, but what if
the data itself is messy. Say you've got metal artifacts
from fillings throwing off the CT surface or the gingiva,
and the optical scan is mobile and doesn't match the
CT perfectly. How do you stop that noise messing up
the best fit?
Speaker 2 (09:58):
Ah? Good question. That's where you need to use the
more advanced tools to essentially clean up the data before
running best fit. The manual highlights two key techniques.
Speaker 1 (10:07):
Okay.
Speaker 2 (10:07):
First, cropping the CT mash. You can use tools like
the three D surface editor to basically cut away and
discard the noisy or unreliable parts of the CT surface
maps like areas around metal restorations that cause.
Speaker 1 (10:17):
Scatter, So you remove the bad data point exactly.
Speaker 2 (10:20):
Second, marking future regions on the alignment object, usually the
optical scan. This is super important.
Speaker 1 (10:25):
Marking feature regions. What does that do?
Speaker 2 (10:28):
You essentially paint or select the areas on the optical
scan that you trust are stable and accurately captured in
both data sets. Typically these are the teeth, surfaces, and
maybe some areas of firm attached gingiva or bone if.
Speaker 1 (10:41):
Visible and the areas you don't mark.
Speaker 2 (10:43):
The areas you leave unmarked, like mobile GINGEEVA or areas
with known discrepancies are ignored by the best fit algorithm.
It forces the software to focus only on matching the reliable,
stable areas you selected.
Speaker 1 (10:55):
AH smart so you guide the algorithm.
Speaker 2 (10:57):
You guide the algorithm skipping these steps. Cropping and the
feature marking is a common reason why surgical guides end
up not fitting quite right. You might be off by
a millimeters or two, which is huge in implant surgery.
Speaker 1 (11:08):
Makes sense. Now there's a warning about virtual objects. Say
I've already placed a virtual tooth model where I want
the final crown to be. When I align the CT data,
it might shift. Should that virtual tooth stay put It.
Speaker 2 (11:22):
Feels intuitive that it should stay put right, but the
manual actually advises strongly against that. Really, because if you
place that virtual tooth or any annotations or collision objects
like a nerve canal, relative to the original position of
the CT scan, then when you align and therefore move
the CT scan data, those virtual objects need to move with.
Speaker 1 (11:42):
It AH otherwise their relationship to the anatomy changes.
Speaker 2 (11:45):
Exactly if you leave them static while the CT data
shifts underneath during alignment, they'll end up in the wrong
place relative to the newly aligned anatomical data. So the
software usually prompts you transform these objects along with the
CT and the The answer should almost always.
Speaker 1 (12:01):
Be yes, okay, good clarification. Now quickly on the dual
scan the CT too CT alignment, you load the patient
CT and the prosthesis CT. What's the absolute key step
there for making sure that guide will be stable?
Speaker 2 (12:13):
It comes back to that isosurface concept again, but this
time applied to the procesis scan. You need to extract
a mesh surface from the processis CT data, and the
critical part is adjusting the surface threshold that isovalue very precisely.
You need to capture the fitting surface of the prosthesis perfectly,
the part that contacts the patients comes. Why is that
surface so crucial Because that extracted mesh surface becomes the
(12:36):
basis for designing the surgical guide. If that mesh has
holes or rough edges, or doesn't accurately represent how the
denture sits on the ridge.
Speaker 1 (12:45):
The guide designed on top of it won't fit right
either exactly.
Speaker 2 (12:48):
It won't see properly. It might rock or skid during surgery.
That leads to inaccurate drilling, and that's a major patient
safety risk. Getting that processis mesh extraction right, is fundamental
for the dual scan workflow.
Speaker 1 (13:02):
All right, alignment's done hopefully perfectly now before placing implants.
Safety means defining critical structures. Let's compare the rule for
the mandibular canal chapter twelve versus sinus segmentation chapter thirteen.
Speaker 2 (13:15):
They seem different, they are treated differently by the software. Yes,
the mandibular canal is top priority for safety because of
the nerve. Precisely defining that nerve canal, drawing the tube
around it using the cross sectional views is mandatory if
you're planning implants anywhere near it.
Speaker 1 (13:29):
And if you place an implant and it hits that
nerve tube collision detection.
Speaker 2 (13:33):
Yes, the software detects the collision. And here's the key difference.
The system will not let you proceed. It flags the
collision and you must resolve it, usually by moving the implant,
before you can finalize the plan.
Speaker 1 (13:47):
It's a hard stop.
Speaker 2 (13:48):
It's a hard stop. It's designed to prevent you from
even finalizing a plan that carries a high risk of
permanent nerve injury. The manual even gives a hint if
you're unsure about the exact nerve path, make the safety
to two diameter a bit larger just to be safe.
Speaker 1 (14:02):
Okay, a definite guardrail there. Now, contrast that with segmenting
the maxillary sinus, which you need to do for upper
posterior teeth numbers fourteen eighteen or twenty four to twenty eight.
Speaker 2 (14:12):
Right, You segment the sinus cavity and that also creates
a collision object. But if you place an implant and
it slightly enters that segmented sinus space, the software handles
it differently. It will give you a warning, definitely, but
it allows you to continue planning if you choose to.
Speaker 1 (14:27):
So I'll lets you override the warning, yes, but it
requires you to acknowledge that you're proceeding at your own risk.
Speaker 2 (14:33):
And this decision gets documented in the final surgical report.
Speaker 1 (14:37):
Why the difference? Why allow collision with the sinus but
not the.
Speaker 2 (14:40):
Nerve Because clinically, sometimes a minor intentional perforation into the
sinus floor is part of the plan, maybe for a
sinus lift procedure or specific implant placement techniques. Uhh okay,
So the software flags the potential issue, but ultimately defers
to the clinician's judgment, making sure the decision is documented.
(15:03):
It highlights your responsibility.
Speaker 1 (15:05):
Understood, so structures define. Now we get to the ideal
planning approach restoration driven or backward planning Chapters fourteen and fifteen.
Speaker 2 (15:13):
Yes, this is about planning the implant position based on
where the final tooth needs to be. You start by
placing virtual library teeth.
Speaker 1 (15:20):
Just dropping a tooth onto the model.
Speaker 2 (15:21):
You can start that way, yeah, place it using contact
points with neighbors, or just position it on the gendiva.
But then the advanced mode gives you some really powerful
tools like instant anatomic morphing. This is really neat.
Speaker 1 (15:32):
What does it do.
Speaker 2 (15:33):
The software can automatically adjust the shape of your virtual
library tooth. It can cut away areas where it intersects
with the opposing teeth the antagonist oh to ensure it
fits the bite exactly, or it can adapt the tooth
shape to create proper contact areas with the opposing teeth.
It helps ensure that wherever you place the implant, the
final restoration will actually function correctly in the patient's bite.
(15:56):
You can even use a slider to simulate natural tooth
where or abrasion.
Speaker 1 (16:01):
So you're designing the tooth first, then planning the implant
to support it.
Speaker 2 (16:04):
That's the essence of backward planning. Yes, prosthetically driven implant placement.
Speaker 1 (16:08):
Okay, tooth position is planned, now finally placing the implant itself.
Chapter sixteen. There's a key safety setting here.
Speaker 2 (16:17):
The safety distance absolutely fundamental. This setting defines a virtual
buffer zone or keepout zone, all around the implant.
Speaker 1 (16:24):
Body, like a protective bubble.
Speaker 2 (16:26):
Sort of. Yeah, the default value is adjustable, but again
the manual issues a strong warning you should only use
a safety distance below one point five millimeters in really
exceptional clinically justified situations.
Speaker 1 (16:37):
One point five millimeters minimum generally generally yes.
Speaker 2 (16:41):
And another important point, the minimum distance maintained between two
adjacent implants is automatically set to double whatever safety distance
you've defined double why to ensure their individual safety zones
don't overlap. If your safety distance is two point zero millimeter,
the minimum center to center distance between two implants will
be kept at four point zero minimeter. It preserves that
(17:03):
buffer around each one.
Speaker 1 (17:05):
Makes sense. How do you visually check that everything is
safe while you're positioning the implant. Are there special views?
Speaker 2 (17:10):
Yes, you heavily rely on the secondary views. There's the
implant crossview, which shows you two cross sections perpendicular to
the implant.
Speaker 1 (17:18):
Okay.
Speaker 2 (17:18):
You can rotate this view around the implant's long axis,
letting you inspect the surrounding anatomy, like how close you
are to the nerve tube or the facial bone plate
or the sinus floor from all angles. And the other
view the implant axial view. This one lets you scroll
up and down along the length of the implant, like
looking straight down the drill hole. It's great for checking
bone quality along the implant path and confirming you have
(17:41):
good purchase in the bone, especially near the APEX hashtag
taghtag V. Surgical Guide Creation and finalization.
Speaker 1 (17:48):
Okay, planning's done, safety checks past the final output we're
aiming for. Is that STL file for printing the surgical
guide itself Chapter eighteen. This sounds like it shifts focus
a bit towards manufacturing constraints.
Speaker 2 (18:01):
It absolutely does. Designing the guide involves parameters that are
dictated less by the patient's anatomy and more by how
you're going to make the guide Specifically, your three D
printer and the material.
Speaker 1 (18:11):
You're using right, like the sleeve mounts critical step Chapter
eighteen point.
Speaker 2 (18:15):
Five very critical. When you design the holes for the
metal guide sleeves, there are parameters like minimum based thickness.
This controls how thick the guide material is beneath the sleeve.
Speaker 1 (18:25):
Flange, and if that's too thin, the guide.
Speaker 2 (18:28):
Could flex under drilling pressure, leading to inaccuracy, or it
might even fracture during the surgery. Not good. This thickness
needs to be appropriate for the strength of your chosen
print material.
Speaker 1 (18:39):
Okay, and the other big one seems to be radial
sleeve offset that sounds like the gap around the sleeve exactly.
Speaker 2 (18:46):
It's the tiny space designed between the outer wall of
the metal sleeve and the inner wall of the hole
printed in the guide. This offset accounts for printing tolerances
and ensures the sleeve fits correctly.
Speaker 1 (18:57):
And getting this offset wrong is bad.
Speaker 2 (19:00):
Very bad in either direction. If the offset is too small,
the hole is too tight and you physically won't be
able to insert the metal sleeve into the printed guide,
the guide is useless. If the asset is too large
the hole is too loose, the sleeve will wobble or spin.
That means the drill isn't stable. It can skid deviate,
completely negating the accuracy you plan for. This can lead
(19:22):
to damaging adjacent teeth or nerves.
Speaker 1 (19:25):
And this offset value isn't universal.
Speaker 2 (19:27):
Not at all. It's one hundred percent dependent on your
specific printer, the resin or material you're using, and even
your post processing methods. You usually need to calibrate and
determine the optimal offset for your particular manufacturing workflow.
Speaker 1 (19:42):
Wow, okay, manufacturing matters. What about the guide bottom chapter
eighteen point six. Setting insertion direction?
Speaker 2 (19:49):
Yeah, this involves defining how the guide will set under
the teeth or tissue. You set an insertion path, and crucially,
you digitally block out undercuts.
Speaker 1 (19:58):
Undercuts like on the teeth.
Speaker 2 (20:00):
Exactly areas below the height of contour on the teeth
or rich. If you don't account for these and block
them out digitally, the physical guide will get stuck or
won't seat fully.
Speaker 1 (20:08):
It'll rock or require force.
Speaker 2 (20:10):
Right leading to pain, trauma, or just an inaccurate fit,
which again compromises the whole point of guided surgery.
Speaker 1 (20:16):
So once all these parts, the main guide body, the sleeve,
holes maybe holes for anchor pins if needed, are designed,
they get merged.
Speaker 2 (20:22):
Yes, the software merges all the design components into one
single STL mesh file. That's what you send to the
three D printer or the LAP.
Speaker 1 (20:30):
And what are the final outputs you absolutely need? Besides
the STL.
Speaker 2 (20:34):
You get the merged guide STL file definitely, and alongside
it you get the comprehensive surgical report. This is vital.
Speaker 1 (20:41):
What's in the report everything.
Speaker 2 (20:42):
Details about the implants used, the dimensions, the safety distances
you said, the specific sleeve and drill kit information for
the chosen system. And importantly, it documents any of those
safety decisions you made, like proceeding despite a sinus collision warning.
Speaker 1 (20:58):
And the final warning about.
Speaker 2 (20:59):
This rep the absolute final check. The manual stresses that
the surgeon must review and validate this surgical report clinically
before starting the surgery, and critically, do not modify the
STL file or any other manufacturing files after they've been
generated by the validated plan. Any modification breaks the link
to the verified plan.
Speaker 1 (21:19):
Got it? One last thing. The software has two ways
of working, Wizard versus expert Yeah.
Speaker 2 (21:24):
Quick ditinction. Wizard mode is like having the software hold
your hand. It guides you through the planning steps in
a fixed logical chronological order, great for learning or for
straightforward cases and expert mode. Expert mode gives you freedom.
It unlocks the full toolbox. You can jump between different
planning steps freely using toolbars or menus. This lets you
do more advanced things like digitally extracting a tooth before planning,
(21:47):
using the three D surface editor for detailed mesh modifications,
or revisiting and tweaking alignment steps without starting over. It's
for the power user who knows the workflow inside out.
Hashtag tag t hashtag my four conclusion and takeaway.
Speaker 1 (22:01):
Okay, so after this deep dive, it's crystal clear. Digital
implant planning with software like Exoplan it's not magic. It's
not a push button thing, not at all.
Speaker 2 (22:10):
It's a very systematic process, heavily reliant on risk management.
Speaker 1 (22:14):
Success really seems to hinge on getting that initial data right,
the scan quality, the vauxel size.
Speaker 2 (22:19):
Absolutely, and then rigorously validating things like density settings and
crucially that alignment.
Speaker 1 (22:25):
Step right the alignment seems key, and then.
Speaker 2 (22:27):
Following all the safety checks marking the nerve, segmenting the sinus,
respecting collision warnings before you even think about generating that
final guide file.
Speaker 1 (22:35):
Precision and patient safety are completely intertwined here.
Speaker 2 (22:38):
They are one of the same. In this context. The
software gives you incredible tools and safety nets, but ultimately
the clinician is responsible for ensuring accuracy every step of
the way, especially as we saw with alignment and those
manufacturing specific settings for the guide itself.
Speaker 1 (22:53):
Okay, so for our final thought, our review question for
everyone listening, let's focus it right on that high risk
area we kept coming back to. Getting the alignment spot
on makes.
Speaker 2 (23:03):
Sense, right, So here's the question. What three critical manual
interventions must you, the user successfully manage within the Exoplan
software during either the CT to mesh or the CT
tow CT alignment workflows. Getting these three things right is
essential to ensure the final surgical guide accurately reflects the
patient's true anatomy, which is paramount for preventing patient harm
(23:26):
during the actual surgery.
Speaker 1 (23:27):
Think about calibrating the initial surface, the manual clicking part,
and how you refine the data the computer uses. If
you can nail those three elements derived from the manual's warnings,
you're setting yourself up for a much safer and more
predictable guided surgery, well said, thank you for taking this
deep dive with us today.
Speaker 2 (23:44):
Plan wisely everyone, and be well.
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