cone beam international magazine of cone beam dentistry

10 I I special _ evolution of dental implantology _Over the past 30 years implant dentistry has evolved into a predictable, even conventional, treatmentalternativeforpatientswhoaremissing teeth. In fact, the art and science of implant dentistry has expanded to include many ancillary supportingmodalitiessuchasbonegrafting,ridge splitting, sinus augmentation, soft-tissue graft- ing, biologic modifiers, 3-dimensional (3-D) imag- ing technologies, CAD/CAM technologies, guided surgery applications, and enhanced restorative materials. Diagnosis and treatment planning for dental implants has dramatically improved with the ad- vent of computed tomography (CT), followed by a proliferation of lower dosage cone beam CT (CBCT) devices. Two-dimensional (2-D) periapical radiographs and panoramic radiography are in herently deficient in their ability to provide accurate diagnostic information for dental implant place- mentandrelatedsurgicalproceduresduetopoten- tial distortion and ability to communicate three- dimensional information related to the maxillo- mandibular anatomy. Prior to the scalpel touching the patient, the ability to assess the individual pa- tient-specificanatomyisnowaclinicalrealitywith advanced imaging technologies and interactive treatment planning software (Fig. 1). The quantity and quality of bone can be determined, aiding clinicians in making educated decisions regarding treatment.Implantreceptorsitescanbeevaluated with ever-increasing accuracy, based upon com- pletevisualizationofthebuccalandlingualcortical plates and intermedullary bone. However it has been stated that “the goal of implant dentistry is not the implant, it is the tooth that we replace.” Therefore if clinicians wish to achieve restoratively or prosthetically-driven im- plant reconstruction there needs to be a complete cone beam1_2014 Fig. 1_Cone Beam Computed Tomography (CBCT) allows for complete three-dimensional views of patient anatomy. Figs. 2a & b_The ability to merge CBCT imaging with intra-oral optical impressions, conventional impressions, or stone casts enhances (a), planning accuracy and template design (b). Figs. 3a & b_The use of interactive treatment planning software allow for simulated implants and abutments to help visualize the link to the proposed tooth. Fig. 1 Fig. 2a Fig. 2b Dental implantology— An evolving treatment modality Author_ Dr Scott D. Ganz, USA Fig. 3bFig. 3a CBE0114_10-14_Ganz 31.01.14 15:49 Seite 1