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ePaper created 2015-03-07, 18:13:20 | version 1.33.01
I case report _ use of CBCT prosthesiswastreatmentplannedthatwouldinclude aninterlockingtypeattachmenttobreakthestressof cross-arch stabilization. Utilizing state-of-the-art CBCT imaging and in- teractive treatment planning software, it is now pos- sibletoaccuratelyassesstherelationoftheboneand implant receptor site to the desired tooth position. Therefore, in the digital milieu, thought must first be given to how the proposed position of the teeth (if they are missing) can be incorporated into the scan. In this case, the patient’s existing dentures were duplicated with a radiopaque material (BariOpaque Salvin Dental Specialties) to be worn by the patient during the scan acquisition. During the scan acquisi- tion,thepatientwearstheduplicatedprosthesiswith the radiopaque teeth. The scan was set at a 0.3mm voxel size (i-CAT). TheDICOMdatacanbeinterpretedwiththenative software packaged with the CBCT device (Tx Studio, ImagingSciencesInternational),oritcanbeexported to a third party 3-D planning software (SimPlant, DENTSPLYImplants)forpurposesofusingtheadvanced treatmentplanningcapabilities.Whenplanningideal implantpositions,itisimperativetouse3-Dplanning software so that the appropriate length and width implant can be placed in the receptor sites. Implants should be placed optimally in the receptor site, away from vital structures, such as the path of the inferior alveolar nerve, and to insure that there is a sufficient volume of bone (Triangle of Bone) surrounding the implant and that the implant position is consistent with the restorative plan.6,7 After careful evaluation, favorable bone height and width was identified for four posterior implants and two anterior implants (Fig. 4). Note that each simulated implant also con- tainedanabutmentprojection(green),whichaligned to the desired radiopaque tooth position. Fig. 4_Simulated virtual implants and abutment projections (green) from the software library represent the actual dimensions of the real implants, and were placed in their appropriate cross- sectional slices consistent with the restorative plan. Fig. 5_Optically scanned denture wax up (red) superimposed on 3-D reconstructed volume of the mandible. 12 I cone beam1_2015 Fig. 4a Fig. 4b Fig. 4c Fig. 4d Fig. 4e Fig. 4f Fig. 5