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Role of Cone Beam Computed Tomography
System in Implant Dentistry- An Overview

Article · October 2014

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Manu Rathee Amit Kumar Tamrakar
Post Graduate Institute of Medical Sciences, Ro… Jamia Millia Islamia
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This paper provides an overview based on assessment of ridge morphology. New Delhi. appropriate diagnosis at initial stages is important factors in determining the success of dental implants. 2014 The Cone Beam Computed Tomography (CBCT) system in all fields of dentistry is well known. University of Health Sciences Rohtak. Haryana. All rights reserved . This is a technology based evolution with transition from two dimensional to three Keywords: CBCT. India 3 Department of Prosthodontics Post Graduate Institute of Dental Sciences Pt.bbbulletin. India 2 Department of Prosthodontics Faculty of Dentistry Jamia Millia Islamia. of Dental Sciences Pt. B. E-mail address: ratheemanu@gmail. Haryana. Journal Home Page www. Hounsfield unit. B. 2014 Accepted 21 Oct. Amit Kumar Tamrakar2 and Mohaneesh Bhoria3 1 Department of Prosthodontics Post Graduate Institute of Dental Sciences Pt.com © 2014 British Biomedical Bulletin.D Sharma. Haryana. hard dental tissue with respect to the quality and quantity. 2014 Received in revised form 20 Oct. India A R T I C L E I N F O A B S T R A C T Received 23 Sep. It is used in Bone quality. University of Health Sciences Rohtak.An Overview Manu Rathee*1. planning dental implant treatment as it assesses the bone and the Bone quantity. University of Health Sciences Rohtak. India.D Sharma. Hence. B. available Corresponding author: Department of bone quality and quantity and technology based guided implant Prosthodontics Post Graduate Institute placement. dimensional imaging in the maxillofacial region.org BRITISH BIOMEDICAL BULLETIN Review Role of Cone Beam Computed Tomography System in Implant Dentistry.D Sharma.

CBCT system units don't the alveolar ridge morphology. Assessment of quality of bone CBCT-guided implant surgery The term “bone quality” is Software-Constructed Surgical commonly used and found in reports on Guides can be fabricated nowadays. Subsequently. Software- mineral amount and its structure. relationship of orientation of the trabeculae. are composed of (CBCT) system high energy photons. in Italy2. but CBCT system presents system units. Several factors like cortical bone and associated concavities can metallic restorations. in Japan1 and Bone quality is of four types: Types Mozzo et al. in the 1990s by Arai et al. anatomical structures. and accurate measurements at a lower dosage  Type 4: Very thin cortical bone with low and is a more preferred option nowadays. is enhanced in bone density determination. Bone quality defined implants. the three-dimensional length and diameter. X-rays. The loss of to Hounsfield units8. provide the appearance of ridge patterns. reliable information. Various implant success and failure5. density trabecular bone of poor strength. So the tissues HU value obtained from one CT system is not Assessment of ridge morphology same as that with a different CT system. CT units and expressed as Hounsfield units (HU). Rathee et al_____________________________________________________ ISSN-2347-5447 Introduction The Cone Beam Computed an important patient based factors in Tomography (CBCT) system was developed determining the success6. software. for 1–4 (Bone Quality Index)7: replacement of missing teeth with dental  Type 1: Homogeneous cortical bone. Hence. more precise measurements are  Type 2: Thick cortical bone with marrow required to bypass damage to vital cavity. if different difficult to assess on two-dimensional technique-related factor is used8. the accuracy of CBCT HU values and considered it a valuable diagnostic aid4. concluded that the 3D images more With advancement in CBCT accurately showed true osseous topography. more precision and accuracy Type 4 bone is commonly found in is achieved with the ‘Software Constructed the posterior maxillary region and associated Surgical Guide’3. As the selection of case with higher failure when compared with the and execution of treatment plan is based on other types of bones4. position. implants. and bone a final prosthesis with adjacent teeth and/or matrix properties. Bone quality parameters to ensure successful implant encompasses skeletal sizes. However. Unlike CT imaging system. or The buccolingual ridge pattern is even with the same machine. bone surgery can be assessed such as implant architectures. it is Constructed Surgical Guides indication: BBB[2][4][2014]598-601 . vital structures. This problem has  Type 3: Thin cortical bone with dense overcome with CBCT which give more trabecular bone of good strength. The images consider as an appropriate scaling system.5. be seen. high implant Bone density can be defined by the success is predictable. narrow crestal ridge system numbers measured on CBCT scans form or knife shaped ridges. used for diagnostic imaging Role of cone beam computed tomography are non-monochromatic. Various methods proposed to convert CT such as irregular ridges. Hence. hardening of the beam. and scattering causes heterogeneity of CT Mc Ginvney et al and Schwartz et al system numbers on CBCT scans.

hip and jaws of Accurate bite registrations are must for edentulous subjects.  Mucosa-supported. The CBCT is considered a far  Flapless procedure. Molteni R. CT rendering tissue density in Hounsfield units system causes the highest radiation dose to for cone beam computed tomography. the salivary glands. Conventional method of surgical stents preparation has been used for many References years. the guide made from vacuum form sheets with the buccal or palatal 1. Clinical. presence of hard and soft tissue defect9. Tammisalo E. CBCT in for conventional surgical guides. A new volumetric CT guides. Blake G. Bone supported 2007. underlying anatomy of bone.  Proximity of adjacent teeth. 5. whereas the CBCT  Approximation to vital anatomic system delivered the lowest dose9. Mucosal. IL: Quintessence Publishing.10. cone-beam computedtomography: current constructed surgical guides in use: perspectives. and lead foils EurRadiol 1998:8. Procacci C. Prospects and challenges of During radiographic imaging. 245–8. Conclusion  Insufficient bone volume. 1985:199–209. machine for dental imaging based on the Traditionally. However. 4. Arai Y. Martini the use of software-constructed surgical PT. Clin Oral Implants Res. various material used were cone-beam technique: preliminary results. this disparity can be nullified. 6:29–43. 2014. structures. Hashimoto K. Development of a compact appear marked disparities in the appliances computed tomographic apparatus for dental to predict the planned position and the use. gutta-percha. preparation of this guide. Mozzo P. supported are used in edentulous situation Crane F. designed for accurate seating. Petersson A. surgical guides used in both cases. Chicago. Jadhav R. 18(4):496–500. 1558–64. Tacconi A. Zarb GA. Palmer RM. Wilson R. 6. Andreis IA. mineral density in the spine. 2004. but they 7. Iwai K. significant ridge atrophy where seating of a Albrektsson T. Lindh C. Maxillary  Bone-supported. Lekholm U. Here. Investigational Dentistry 2014. But there Shinoda K. 98(1):102–9. only SimPlantR manufacture Dentistry. Jaju SP. Prostheses: Osseointegration in Clinical Currently. 8. Oral BBB[2][4][2014]598-601 . A comparison of bone and are designed to rest on the mucosa. Thareja A. bone supporting surgical guides. 3. Obrant K. Patient selection and are primarily used in edentulous cases with preparation. Drage NA. Fogelman I. with 2. 6(2):100-5. Indian Journal their application seemed limited in the of Dental Sciences. Dentistry: A Literature View. Evidence based research still needs to Software-constructed surgical guides Vs evaluate its applications and effect on the conventional surgical stents dental implant based treatment outcome. DentomaxillofacRadiol 1999:28. barium sulfate. Zarb GA. bone mineral density and its relationship to Tooth-supported surgical guides are the bone mineral density of the lumbar spine and hip. However. superior as the imaging system that facilitate  Multiple full-arch restorations. Rathee et al_____________________________________________________ ISSN-2347-5447  Multiple implants in a quadrant. Jaju PP. facings of the planned restorations. Oral Surg Oral Med Oral Pathol used for partially edentulous cases and Oral Radiol Endod. Cosmetic and  Tooth-supported. planning and guidance during the surgical phase. Tissue-Integrated mucosa supported guides posed problem. Clinical utility of dental There are three types of software. In: Branemark PI. Sabane AV. editors.

Comparison of radiation 2013. Rathee et al_____________________________________________________ ISSN-2347-5447 Surg OralMed Oral Pathol Oral Radiol. Fung K. dose for implant imaging using conventional 9. Orentlicher G. 10. Oral 2011. Guided surgery spiral tomography. and cone-beam computed tomography. 116(1):105–19. for implant therapy. 55(4):715–44. computed tomography. Chau AC. Abboud M. Dent Clin North Am. Surg Oral Med Oral Pathol Oral Radiol Endod. BBB[2][4][2014]598-601 View publication stats . 2009. 107(4):559–65.