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| case report 34 implants 1 2016 Fig. 10: Axial CBCT slice demonstrates the height of the extraction socket is 8 mm Fig. 11: Deep SF. Fig. 12: CBCT images providing a virtual implant position and angulation. Contact Dr Souheil R. Hussaini, BDS, MS Oral Implantology Medical Center 204 Al Wahda Building, Port Saeed Rd, Deira, P O Box 39695 Dubai, UAE Tel.: +971 4 2956595 Fax: +971 4 2958757 souheilh@eim.ae www.ID-SC.com Fig. 10 Fig. 11 Fig. 12 computed tomography technology, bring ad- vances to the study of the anatomic landmarks. Several authors emphasise how implant placement has been improved by using preoperative CTs for the success of surgical treatments. Precise 3-D vi- sualisation of the edentulous area and conse- quently the insertion of the implant can be ob- tained through the use of CBCT imaging, facilitat- ing computer-assisted planning of oral implant surgery.6,10,21,26 Even though, the technology of cone beam computed tomography is rapidly improving, the benefits of a CBCT investigation must outweigh any potential risks.4,5,27,28 Based on one hundred spiral computed tomo- graphic (CT) preoperative examinations of patients requiring assessment of the lower jaw, before im- plant placement samples, Parnia F et al. classified the depth of the submandibular gland fossa as a function of the lingual concavity depth over a range of up to a maximum value of 6.6 mm.2 Man- dibular lingual concavity depth was divided into three groups. A lingual concavity (depth ≥ 2 mm) was observed in 80 % of the jaws. In 20 % of the cases, there were flat depressions less than 2 mm in depth (Type I) and in 52 % of the cases the con- cavities were two to three mm deep (Type II). About 28 % of the examined regions showed significant concavities of more than three mm (Type III). The obtained distribution did not reveal any depen- dence on age and gender of the patients examined in this study (P > .05). Kobayashi et al. found that measurement errors ranged from 0 to 1.11 mm (0 % to 6.9 %) on CT and from 0.01 to 0.65 mm (0.1 % to 5.2 %) on CBCT, with measurement errors of 2.2 % and 1.4 %, respectively (P .0001).29 Based on those results, this study suggests that distance can be measured accurately by using CBCT. Lascala et al. concluded in their study that, although CBCT image underestimates the actual distances be- tween skull sites, differences are only significant for the skull base and therefore it is reliable for lin- ear evaluation measurements of other structures more closely associated with dentomaxillofacial imaging.30 According to Chan HL et al. the incidence of lin- gual plate perforation during implant placement is predicted to be 1.1 % to 1.2 % and will most likely happen in type-U ridge.3 Conclusion Images acquired using two-dimension (height and width) radiography cannot reveal valuable in- formation in third-dimension (depth). This fact limits its use. In certain situations, for example deep SF for implant selection, three-dimensional visualisation of the anatomical limitation is desir- able. In those circumstances, three-dimensional imaging provided by CBCT is extremely valuable. In comparison to panoramic radiograph, the use of CBCT can greatly improve the visualisation leading to a more definitive diagnosis and the best possible treatment plan._ The author declares no conflict of interest. Editorial note: A list of references is available from the publisher. 12016 Tel.: +97142956595 Fax: +97142958757