From CT Scan to Treatment Plan: How Surgeons Design Your Arch

The treatment plan is the blueprint for your entire full-arch restoration. It determines how many implants you need, where they go, whether bone grafting is required, and what your prosthesis will look like. Understanding how it is created helps you ask better questions and evaluate whether a surgeon's recommendation is well-reasoned.

The CBCT scan

A cone-beam computed tomography (CBCT) scan is a 3D X-ray of your jaw and skull. Unlike a traditional dental X-ray (which is flat), a CBCT scan produces a three-dimensional model that your surgeon can rotate, slice, and measure. It shows bone density, bone volume, the position of anatomical structures (nerves, sinuses, blood vessels), and the condition of any remaining teeth and roots.

The scan takes about 30 seconds and delivers significantly less radiation than a medical CT scan. It costs $150 to $350 in the US, $40 to $120 in Colombia, and can be done at any dental imaging center or equipped dental practice. Most surgeons require a CBCT scan less than 6 months old.

Surgical planning software

Your surgeon imports the CBCT data into surgical planning software (common platforms include Nobel Biocare's DTX Studio, Straumann's coDiagnostiX, and Blue Sky Plan). In this software, the surgeon virtually places each implant — specifying the position, angle, depth, and diameter — and verifies that each implant engages adequate bone, avoids critical anatomy, and creates a viable prosthetic support pattern.

This is where the surgeon decides whether you need All-on-4, All-on-6, zygomatic implants, or preliminary grafting. The software shows exactly how much bone is available at each potential implant site, measured in millimeters.

Guided surgery vs freehand

Based on the virtual plan, some surgeons fabricate a 3D-printed surgical guide — a custom template that fits over your jaw and directs the drill to the pre-planned position. Guided surgery reduces operative time, improves accuracy, and is especially valuable for zygomatic implant placement.

Other surgeons work freehand, using the virtual plan as a reference but relying on surgical experience to position implants. Both approaches produce excellent results in experienced hands. Guided surgery adds $500 to $2,000 to the cost but reduces variability.

What your treatment plan should include

A complete treatment plan for full-arch implants should specify: the number and brand of implants, the planned position and angulation of each implant, whether bone grafting or sinus lifting is needed, the provisional prosthesis material and timeline, the final prosthesis material (zirconia vs acrylic-over-bar), the total cost (both visits itemized), and the expected timeline from surgery to final teeth.

For candidacy criteria, see Am I a Candidate?. For the step-by-step process, see All-on-4 Explained.