In computer-guided implantology, surgical precision is fundamentally limited by the quality of input diagnostic data. Even the most advanced planning software or high-resolution 3D printer cannot compensate for distorted intraoral scans or artifacts in computed tomography. ANPA Medical Supplies DMCC—an ISO 13485-certified pioneer in digital dentistry based in Dubai—has developed standardized diagnostic protocols for its AxisGuide® system. By matching specific imaging requirements to patient dentition, clinicians ensure flawless 3D treatment planning and optimal surgical guide seating.
Partial Edentulous Cases: Dual Data Acquisition
For single-tooth restorations, short-span bridges, or partially edentulous arches, accurate guide fabrication relies on merging hard-tissue radiologic data with soft-tissue surface scans.
- CBCT or Spiral CT Scan: Provides high-resolution three-dimensional imaging of underlying bone volume, trabecular density, and critical anatomical structures such as the inferior alveolar nerve and maxillary sinus cavities.
- Digital Surface STL File: Captures sub-millimeter details of remaining dentition, gingival contours, and occlusion. This file can be generated via an intraoral scanner (IOS) or by digitally scanning a traditional plaster cast.
In the AxisGuide® planning software, these datasets are aligned using anatomical tooth landmarks, allowing for the design of precise tooth-supported surgical guides that snap securely into place.
Full Edentulous Cases: The Double CT Scan Protocol
Planning guided surgery for fully edentulous arches presents a unique clinical challenge due to the lack of rigid dental landmarks required to align CT scans with soft-tissue impressions. To resolve this, AxisGuide® utilizes two distinct Double CT Scan Protocol options:
Option 1: Duplicated Denture Scanning Appliance
- Protocol: A radio-opaque scanning appliance is fabricated from a duplicate of the patient’s existing, well-fitting denture.
- Execution: A single CT scan is taken with the appliance in place. This single dataset provides adequate visualization of underlying bone anatomy, mucosal support, and intended prosthetic tooth placement.
Option 2: Gutta-Percha Marker Double Scan
- Appliance Preparation: The patient’s well-fitting removable denture is modified by drilling 5 to 6 strategically placed holes (2 mm in diameter) into the denture base plate, which are then filled with gutta-percha.
- Scan 1 (Patient + Denture): A CBCT scan is taken with the patient wearing the modified denture in centered bite alignment.
- Scan 2 (Denture Alone): A second CBCT scan is performed on the denture by itself sitting on the scanner bed.
- Digital Alignment: AxisGuide® software detects the radiopaque gutta-percha markers in both scan sets and automatically overlays them, creating an exact 3D alignment of mucosal support, planned teeth positions, and bone anatomy.
Bone-Supported Guides and Bone Reduction Protocols
When treating severe ridge resorption or executing immediate load full-arch cases requiring surgical alveoloplasty, mucosa-supported guides may not offer sufficient stability. In these scenarios, a bone-supported or bone-anchored surgical guide is indicated.
- Imaging Requirement: High-resolution CBCT or Spiral CT scans are indispensable.
- Clinical Purpose: Detailed 3D volumetric views permit precise mapping of bone contours, enabling the design of bone-reduction jigs and fixated guide frames that sit directly against the bony architecture.
Scan Protocol Summary by Clinical Indication
Clinical ScenarioPrimary Radiologic DataSurface / Appliance DataAlignment Method
| Partially Edentulous | CBCT or Spiral CT | STL file (Intraoral scan or plaster model scan) | Tooth-borne surface registration |
| Fully Edentulous (Option 1) | Single CBCT / CT | Duplicated denture scanning appliance | Anatomic & appliance registration |
| Fully Edentulous (Option 2) | Double CBCT Scan | Existing denture with 5–6 gutta-percha markers (2 mm) | Automatic gutta-percha landmark overlay |
| Bone-Supported / Reduction | High-Resolution CBCT / CT | Bone segmentations derived directly from CT | Direct bone architecture registration |
Connecting Diagnostic Scans to Final Fabrication
Once diagnostic scans are captured according to protocol, case submission proceeds smoothly through the ANPA digital order portal. Practices log in, upload DICOM CT datasets alongside surface STL files, and specify surgical requirements. All client data is archived securely for 5 years in compliance with ISO 13485 standards.
In under 24 hours, clinicians receive a completed treatment plan inside AxisGuide® software for review and validation. Following approval, guide fabrication can occur via ANPA’s global delivery service—where guides are 3D-printed at 50-micron resolution using certified biocompatible resin—or via local export, allowing immediate STL printing in the clinic or laboratory. Adhering to structured scanning protocols guarantees that digital precision translates directly to clinical success in the operating chair.