What this is
A feasibility assessment is a separate piece of work from designing an appliance, and it is worth buying on its own. You send the CBCT and the scan; we tell you whether the case supports what you are planning, before anything is made.
It is the cheapest step in the whole sequence and the only one that can prevent the expensive ones.
What we measure
- Cortical thickness at every candidate screw site, reported individually rather than averaged — the appliance needs specific sites, not a mean
- Whether bicortical engagement is achievable at each, given the palatal and nasal cortices as they actually are
- Midpalatal suture maturation stage, against the Angelieri classification
- Root proximity and canal position, which narrow the usable window further
- Vertical bone height available for the screw length the design requires
Thresholds are agreed with you rather than imposed. Different clinicians accept different margins, and the number that matters is the one you are prepared to work to. We report the measurement; you set the bar.
The three possible answers
Proceed
The sites support the design. We say which sites, with the numbers, and go on to design.
Modify
The original plan does not work but an adjusted one does — screws relocated to sites with better bone, a changed force vector, a different abutment strategy. You get the modification and the reasoning, and you decide whether it still achieves your objective.
Decline
The bone will not support it anywhere useful, or the suture will not open. We say so plainly and suggest the realistic alternative — frequently a surgically assisted approach, sometimes a different treatment objective altogether.
Declining is not us refusing work. It is the work. A case that was never going to succeed still consumes your chair time, the patient's patience and your reputation when it fails.
What you receive
- The measurements, site by site
- The suture staging with the images it was read from
- A written recommendation with the reasoning, not just a verdict
- Where relevant, the alternative approach and what it would need
Written down, because you may need to show it to the patient, and because a recommendation you cannot reproduce six months later is not much use.
Where this fits
Ideally before you have promised the patient a specific appliance. A feasibility assessment that arrives after the consent conversation is doing half a job.
On the choice between approaches: MSE, MARPE and SARPE — what decides which.
Timeline
Same or next working day. It is a reading and measuring task, not a design task, and it should not sit in a queue behind one.
Planning and design support only. Diagnosis, treatment planning and the clinical decision remain entirely with the treating clinician.