[Teamwork and communication in implantology: dentist--technician--implant surgeon]

The importance of presurgical communication and cooperation between the restorative dentist, dental technician, and the implant surgeon is well recognized in modern implantology. The predictable outcome of function and aesthetics of intraoral rehabilitation can and must be determined and controlled prior to the surgical procedure, with the entire restorative team cooperating from treatment planning to the completion of the prosthetic procedure. The paper reviews the assessment of bone height and width by intraoral measurements and preexisting formulae, the use of radiographs, model analysis, and implant placement on model. A particular implant system (Steri-Oss, Yorba Linda, CA) is used. The rationale for angulating implants, originating from the shape of the bone is discussed. The optimal implant position can be determined only by a set-up; the drill jig copies the information from the articulator to the intraoral arch and provides the surgeon with a maximum assurance of the outcome. The try-in and changes are discussed, followed by the actual surgical procedure. After the healing period, use of the jig can assist in implant recovery. The wax-up can be used to maintain silicone vestibular walls and help to model the gold frame of the laboratory work. The emphasis is placed upon the cooperative teamwork of the restorative team, especially the contributions of the laboratory and other technology to the functionally and aesthetically successful final result.