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ePaper created 2016-06-21, 09:24:47 | version 1.38.0
| case report use of CBCT 08 cone beam 2 2016 In the present case, no periosteal elevation was per- formed (Fig. 6) and the patient did not have post- operative pain and swelling. CBCT is a modern technology, which allows the three-dimensional evaluation (sagittal, axial and coronal) of maxillofacial structures. Among its many advantages are the absence of superimposition of structures in obtained slices, acquisition of a 3-D re- construction (spatial vision for illustrative purpose), aswellastheuseoflowerradiationdosesincompar- ison to medical CT.15–17 SF location, size, shape and its possiblevariationscanbefullyassessedbyCBCT.2,3,18–22 Due to the limitations of periapical and panoramic techniques, the radiographic assessment of SF is not always available. Jacobs et al. reported that SF was detected in 94 % of their assessed panoramic radio- graphs,butonly49%ofthosewereclearlyvisible.23–25 Therefore, it can be reasonably concluded that the lack of observation of SF in conventional radiograph does not prove its actual absence. Inourreportedcase,wewereabletoevaluatetheman- dible of the patients in 3-D and here SFs were actually deeplyprominentandhypoplastic.Also,itwasimpos- sible to perform the surgery without 3-D imaging. A preoperative imaging study is important prior to any surgical procedure in the posterior mandibular region.2,8 CBCTcanbeveryhelpfulforthedetectionof SFvariationsthatcouldbeotherwisemissedusingcon- ventional radiographic examination techniques.2, 5, 7, 10 Inthepresentcase,thediagnosisoftheanatomiclim- itationwaspossibletobevisualisedduetoCBCTexam- ination. Furthermore, the accurate measurements of SFandthevisionof3-Dspatialreconstructions,which areexclusivetoolsofcomputedtomographytechnol- ogy,bringadvancestothestudyoftheanatomicland- marks.Severalauthorsemphasisehowimplantplace- menthasbeenimprovedbyusingpreoperativeCTsfor thesuccessofsurgicaltreatments.Precise3-Dvisual- isation of the edentulous area and consequently the insertion of the implant can be obtained through the use of CBCT imaging, facilitating computer-assisted planning of oral implant surgery.6, 10, 21, 26 Even though, the technology of cone beam computed tomographyisrapidlyimproving,thebenefitsofaCBCT investigationmustoutweighanypotentialrisks.4,5,27,28 Basedononehundredspiralcomputedtomographic (CT) preoperative examinations of patients requiring assessment of the lower jaw, before implant place- ment 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 max- imumvalueof6.6mm.2 Mandibularlingualconcavity Fig. 8: Panoramic radiograph, one-year post-op. Fig. 9: Bone width lingual wall 1.9mm and buccal 2.5mm. Fig. 9 1.90 2.50 Fig. 8 22016