ROLE OF CBCT IN

IMPLANT DENTISTRY

PRESENTED BY-
DR. SHREYA SINGH
DR. PRASHAL LAHARE
Dept. of Prosthodontics, Crown & Bridge
 INTRODUCTION
• Radiographs, commonly known as X-rays, play a fundamental role in
modern medicine by providing clinicians with detailed images of internal
structures, aiding in the diagnosis and treatment of various medical
conditions. More than a quarter of all medical radiographs are taken by
dentists
• The significance of radiographs for dental diagnosis is illustrated by the fact
that hardly 2 weeks after the reported discovery of X-rays in 1896, a
German dentist (O. Walkhoff) had already made the first radiographic image
of human teeth
• For more than a century, this type of dental radiograph was the principal
source of diagnostic information on the maxillofacial complex. Yet, two-
dimensional projective techniques cannot fully display complicated three-
dimensional anatomic structures and related pathologies.
• Clinical complexity, regional anatomic
considerations, potential risk of
complications, and esthetic considerations
in the location of implants are factors that
determine the individual clinician’s needs
for information supplemental to that
already obtained from the clinical and
radiographic examinations (periapical and
panoramic) to formulate a diagnosis and to
assist in implant therapy treatment planning
• The introduction and widespread use of
CBCT over the last decade has enabled
clinicians to diagnose and evaluate the jaws
in three dimensions, thus replacing CT as
the standard of care for implant dentistry
 WHAT IS CBCT?
CBCT stands for Cone Beam Computed Tomography. It's a specialized
type of medical imaging technique used primarily in dental and
maxillofacial imaging. CBCT provides high-resolution, three-dimensional
images of the teeth, jaws, and surrounding structures.
Unlike traditional medical CT scans, which use a fan-shaped X-ray beam,
CBCT employs a cone-shaped X-ray beam, allowing for precise and
detailed imaging of the oral and maxillofacial regions

CBCT imaging must provide information supportive of the

following goals:
• To establish the quantitative bone availability
(morphologic characteristics) of the residual alveolar ridge.
• To determine the orientation of the residual alveolar ridge.
• To identify local anatomic or pathologic boundaries within
the residual alveolar ridge limiting implant placement
APPLICATIONS OF CBCT IN IMPLANT DENTISTRY
PRE-OPERATIVE ASSESSMENT-
Radiographic assessment of the 3D implant
position, angulation, and restorative space is
essential during preoperative diagnostics and
treatment planning of implant sites within the
residual alveolar bone.
BONE QUALITY AND QUANTITY
ASSESSMENT- Essential preoperative assessment
should include an evaluation of the saddle
length(mesiodistal), vertical bone height (occlusal-
apical), and horizontal width(buccolingual) bone
availability of the proposed implant recipient site to
facilitate proper planning, correct implant selection,
3D placement of the dental implant, and the
necessity for implant site development.
IMPLANT SITE SELECTION AND
EVALUATION
NERVE CANAL AND SINUS
EVALUATION- Each location in the dental
alveolus has unique morphologic and
topographical characteristics owing to
edentulousness and specific regional anatomic
features that need to be identified and assessed in
the diagnostic and treatment-planning phase of
dental implant therapy
 COMPUTER-ASSISTED
PROSTHETIC AND SURGICAL
TREATMENT PLANNING-
Via CAD/CAM solutions, CBCT
DICOM data can be merged with STL
files to produce 3D models. Surgical
guides/stents can be made.

POST OPERATIVE ASSESSMENT

OF FAILURES AND
COMPLICATIONS
• Altered sensation and possible damage
to neurovascular structures
• Infection or postoperative integration
failure
• Perforations
Implant perforating the lingual cortical plate • Implant displacement
 ADVANTAGES OF CBCT IN IMPLANT DENTISTRY
Precision placement of
implants in the bone
Allows the surgeon to accurately
measure and localize the available
bone and accurately place the
implant in a correct 3D position
Selection of the right size
implant for optimal support
The longevity and success of
dental implants require maximal
integration and stability in the
bone. CBCT allows the surgeon to
measure the available bone and to
select the widest and longest
implant appropriate for the site
Proper orientation of the
implant with its overlying
restoration Prevention of injury to
A CBCT can be merged with an nerves and penetration into
optical scan of the patient’s teeth
the sinus
to create a complete digital model
of the patient’s bone, teeth, and
soft tissues
Communication of data volume
CBCT allows the ability to
communicate DICOM data Improved clinical outcomes
imaging information for prosthetic and reduced risk of
restorative planning, and design complications
and manufacturing of surgical
guides
 Relatively Requires
costly compared training and
to traditional X- has a
rays learning
curve

Requires
expertise and
LIMITATIONS OF CBCT specialized Radiation dose
equipment

Poor soft tissue Imaging

contrast artifacts
 CONCLUSION
• CBCT imaging technology computer software has significantly increased the
accuracy and efficiency of diagnostic and treatment capabilities, thereby offering
an unparalleled diagnostic approach when dealing with previously challenging
unknown anatomical and/or pathological entities in implant dentistry

• The potential benefits for accurate assessment, diagnosis of pathologies,

identification of anatomical landmarks and neurovascular structures, as well as
topographical and morphological deviations in alveolar bone, in preoperative
treatment planning are undisputed

• CBCT has increasingly become the new professional standard of care in implant
dentistry. With this technology, adequately trained clinicians can enhance their
practice and best serve the interests of their patients
 REFERENCES

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