How to round-trip an implant case between Cympha Studio and GuideMia Implant Software

The .pie and .imp round-trip lets Cympha Studio open, edit and hand back a project from GuideMia dental implant software, so browser review and desktop planning work on the same implants.

Audience: Clinicians and implant designers collaborating across Cympha Studio (browser) and GuideMia Implant Software on the desktop. Either side may have created the case; either side can review, adjust, comment, and hand it back.

You'll come away knowing: how to open a colleague's .pie project in Studio, review and edit the implants, read and append to the design log, optionally swap in a .imp plan exported from elsewhere, and save back to the same .pie so the desktop application picks up your changes cleanly.

Time required: About fifteen minutes for the first case — most of which is verifying you have the right DICOM. Five to ten minutes per case after that.

Before you start

You need:

The colleague's .pie project file.
The matching DICOM folder — the original CBCT series the .pie was planned against. Cympha Studio matches a .pie to a CT by Series Instance UID, the same identifier GuideMia Implant Software uses. A CT from a different patient, or a re-exported series with a new UID, will not match.
Cympha Studio open at studio.cympha.com.

If you only have the .pie and not the DICOM, ask the sender to share the CBCT folder before continuing — implants in a .pie are positioned in CT voxel space, so Studio cannot render them in 3D without the matching volume.

Step 1 — Switch to the Implant workspace

In the top bar, open the Workspace nav and pick Implant. The hamburger menu narrows to the file actions for implant work: DICOM, implant project (.pie), optical scan, pictures, open URL, reset camera, clear scene, user guide.

Opening a .pie deep link from a colleague's email or URL share switches you to Implant automatically, so you usually don't need to set this by hand.

Step 2 — Open the DICOM first

DICOM has to be in the scene before the .pie loads, because Studio needs the volume to render implants in 3D and to verify the patient match.

☰ → Open DICOM….
Choose the folder containing one CBCT series. Studio decodes the series in the browser; nothing is uploaded.
Wait for the MPR slice rows to appear — that's the signal the volume is ready.
Optional: open the View tools panel from the left floating strip and tweak HU threshold (the slider runs roughly −1024 … 2048) and Opacity so bone is easy to see. You'll need this contrast in Step 4 and beyond.

If your deployment has cloud implant APIs and you opened DICOM through this menu, Studio may offer to import a cloud treatment plan for this series. Skip the prompt if you're about to open a .pie for the same case — the .pie will provide the implants.

Step 3 — Open the `.pie` project

☰ → Open implant project…. The file picker is restricted to .pie.
Pick the colleague's file.

What happens next depends on whether the DICOM matches:

If it matches: the implants load immediately. The Models browser opens automatically and the Implant tools toolbox in the left strip unfolds so the parameter panel and design log are visible.
If it doesn't match (no DICOM loaded yet, or the loaded CT belongs to a different patient): Studio shows a DICOM required for this implant project dialog. The dialog names the patient stored on the .pie when that information is available. Click Open DICOM inside the dialog and pick the correct folder; once Studio confirms the Series Instance UID matches, the implants load automatically.

You cannot save implants back to a .pie while DICOM is mismatched — Studio blocks the write on purpose so a plan can't be silently re-anchored to the wrong scan.

Step 4 — Review the existing implants

In the Models browser, each implant appears as its own row. When the .pie carries the data, Studio enriches the row with:

Brand and series (for example a manufacturer name plus product line).
Total drilling length.
Sleeve dimensions as ID × OD × H in millimetres.

Click an implant row to make that implant the current implant in the Implant tools toolbox — the panel's diameter, length, apical, brand, and catalog ID fields populate with the values from the .pie. Use this as a sanity check before you start editing anything.

To inspect the implant in 3D and on slices:

Double-click the implant body in the main 3D view to open positioning (gizmo). Drag the axis handles to translate, the rotation rings to tilt.
With positioning active, the View tools panel offers a Gizmo MPR mode that aligns the slice panes to the implant axis — useful for verifying parallelism with adjacent roots or sleeve clearance from the inferior alveolar nerve.

Step 5 — Read the design log

The design log is the planner's running commentary, stored inside the .pie itself. While the project is open, the Implant tools toolbox shows existing log entries grouped by author, in the order GuideMia Implant Software wrote them. Read these before you change anything — the previous designer probably explained why placements are where they are.

Step 6 — Add or update an implant

For a new implant:

In the Implant tools toolbox, optionally click Open catalog… to load the embedded XML catalog and pick a brand/size. Selecting a catalog row fills the diameter, length, apical, brand, and catalog ID fields.
Enter the universal tooth number (1–32). If that tooth already carries an implant, Studio shows an alert and refuses — pick another tooth or remove the existing implant first.
Click Add. The status line at the bottom prompts: "click in 3D or a slice view to place."
Click the desired site in the 3D view or on any MPR pane. The implant appears with its sleeve at the clicked point.
Refine position with the gizmo in 3D, or the gizmo on the slice panes.

For an existing implant:

Click the implant row in the Models browser to make it current.
Edit the diameter/length/apical/catalog fields in the panel.
Click Update to regenerate the geometry. Update is disabled while a placement is still pending — finish the click for Add first.

Step 7 — Add your review comment to the design log

Below the existing log entries, the Implant tools toolbox shows a textarea and an Add comment button.

Type your comment — for example "Reduced 16 length to 10 mm for sinus clearance; verify on coronal at z=…". Be specific; this is what the next reviewer will read.
Click Add comment, or press Ctrl+Enter (Cmd+Enter on Mac) inside the textarea.

Your comment is appended to the design log under your name. The change is persisted to disk on the next Save project.

Step 8 — Save back to `.pie`

☰ → Save project. Studio writes implant changes (new placements, transforms, design-log additions) back to the same .pie filename.

What gets preserved when Studio saves:

Every implant, sleeve, transform, and metadata field Studio modified.
Every non-implant Segment and attribute the desktop application wrote — Studio retains the full XML document and only rewrites the pieces it modelled. A planner reopening the file in GuideMia Implant Software won't see surprises.

The status line confirms the saved filename. Send the updated .pie back to the colleague; they can reopen it in either GuideMia Implant Software or Cympha Studio and pick up exactly where you left off.

When to use `.imp` instead

.imp is the Studio-native implant-plan file (XML metadata only — not mesh blobs). It's useful when:

You don't have a .pie yet but want to share an implant plan with someone using a different desktop application.
You want to import implant positions from another tool that exports .imp.

Inside the Implant tools toolbox:

Export plan writes all current implants to a .imp file you download.
Import plan loads placements from a .imp, adds sleeves, and skips teeth that already have an implant so you don't double-place by accident.

.imp and .pie are not interchangeable. While a .pie is the active project, ☰ → Save project writes back to that .pie. To produce an .imp from the same scene, use Export plan in the Implant toolbox.

What happens next

The .pie you saved is the same file the desktop application opens. There's no separate "Studio version" of the project — both applications read and write the same XML document, and Studio's full-XML preservation means non-implant Segments survive every round trip.

For ongoing collaboration:

The colleague opens the saved .pie in GuideMia Implant Software, reads your design-log entry, and either accepts your changes or replies in the next entry.
They save and send the file back. You ☰ → Open implant project… again — Studio matches against the still-loaded DICOM and you pick up the new state.
Project pictures and screenshots travel separately from the .pie. If you want gallery captures attached to the case, save a Cympha .cyp project alongside the .pie (though note: while a .pie is the active project, .cyp save targets are suspended in the same session — the two formats are mutually exclusive, so switch projects via the relevant menu entries).

Troubleshooting

The DICOM-required dialog appears even though I loaded DICOM. The Series Instance UID on your DICOM doesn't match the one stored in the .pie. The most common cause is a re-exported CBCT — many viewers reassign UIDs on export. Get the original DICOM folder from whoever captured the CBCT, not a derived copy.

The implant browser rows look bare (no brand or sleeve dims). Older .pie projects or projects from third-party importers may not carry the enriched fields. The implants will still render and edit; only the row summary is sparser.

I can't open a .pie and a .cyp at the same time. Correct — the two formats are mutually exclusive in a single Studio session. Save your work in one, then open the other. The menu's enable/disable state reflects which save target is currently active.

Save project did nothing visible. Watch the status line at the bottom of the viewer — Studio reports the saved filename there. If the browser blocked the file write (some configurations require user gesture in the same tick), retry Save project from the menu directly rather than via keyboard shortcut.

The design log textarea won't accept Ctrl+Enter. That shortcut is only handled while focus is inside the textarea. Click into the textarea first, then press the shortcut. Outside the textarea, Ctrl+Enter has no effect.