The Chal-Hatcher Guide

Driven by a desire to provide the best treatment for his patients, in 2006 Dr. Chal, working with his dental implant radiologist, Dr. David Hatcher, developed what has become known as the Chal-Hatcher Guide. They have subsequently taught this concept to many dentists in international audiences.

The problem Dr. Chal found in earlier concepts of dental implant treatment is that the implant design tools dentists used were developed with backwards planning. They started from the placement of the implants, and then planned the teeth around them. This made it difficult to customize the treatment for each patient. It resulted in a "one size fits all" approach, which made it easy for the surgeon, but he didn't feel it was in the best interests of the patient.

Dr. Chal, with his dual background in advanced cosmetic dentistry and advanced implant dentistry, was more sensitive to the demands of appearance and the function of the teeth. So he and Dr. Hatcher developed the Chal-Hatcher Guide, in which they start with the proper placement of the teeth, according to the demands of facial attractiveness and function, and then plan the placement of the implants to achieve that end.

They begin with a thorough diagnostic workup, in which Dr. Chal and his master implant technician first create a prototype of the correct placement of the teeth. Precise air holes are drilled in this prototype. These air holes show up as dark lines in the CT scan, and enable exact correlation between the prototype and the scan.

They then take a series of CT scans in one-millimeter "slices" (which involve a very small amount of radiation).

They carefully analyze these, and then Dr. Chal marks up the guide and a silicone model of the patient's arch. He then meets with the surgeon and together they plan the exact placement of the implants.

Here is a photograph of a set of guides for an actual patient. It contains precise instructions to the surgeon to help insure a optimum implant placement.

This is a model of a final result. There used to be holes for access to the dental implants, and screws were placed in those holes to attach the teeth to the jaw. However, notice that the holes have been restored and you can't tell, from the outside, where they are.

The Chal-Hatcher Guide is used to develop all of the dental implant options. The model above is of a fixed denture/implant hybrid, but it is used with the other options as well.

Unfortunately, many dentists just let the surgeon place the implants and then try to work around the results. This will limit the design of the final restoration, forcing the dentist into a "one size fits all" treatment plan. Dr. Chal always uses careful planning and uses this Chal-Hatcher guide so that the end result is fully customized to each patient, placing the teeth in the best position for ultimate attractiveness, function, and comfort.