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CAD/CAM international magazine of digital dentistry No. 3, 2016

CAD/CAM 3 2016 | cone beam supplement research 44 CBCT zones of the jaw Bone quality related to implant location Author: Dr Souheil R. Hussaini, UAE Introduction The causes of early implant failures during the osseointegration process include poor quality and quantity of bone and soft tissue,1–8 the patient’s medical condition,2,6,8–10 unfavorable patient habits (bruxism, heavy long-term smoking, poor oral hy- giene, others),3,4,6,8,11 inadequate surgical analysis and technique3,7–9,11 inadequate prosthetic analysis andtechnique,3,7,8,11–13 suboptimalimplantdesignand surface characteristics6,9,13 implant position or loca- tion14 and unknown factors. This article attempts to further investigate implant location as one of many factors in early stages of diagnosis that improves success rate in implant dentistry treatment. Predisposing factors to implant complications in different jaw regions are discussed. CBCT Zones D1 to D5 is formulated to better ana- lyse implant dentistry procedure preparation during thediagnosticphasebasedonthelocationthathasa logical sequence during examination of the alveolar ridgeofbothmaxillaandmandibletohavepre-exist- ing information regarding the demands and the clin- ical requirements in different zones of the jaws. This article identifies the Hounsfield units (HFU) of differ- ent alveolar jaw regions, according to which dental implants can be inserted with better understanding of what to expect. FiveCBCTzonesareidentifiedinthisarticleinalog- icalsequence:thediscreetzoneD1beingtheanterior mandible, the danger zone D2 being the posterior mandible, the death zone D3 being the anterior max- illa, the demand zone D4 being the posterior maxilla and the delicate zone D5 being the posterior maxilla that requires sinus lift procedure. Zones D1–D5 are related to the bone quality clas- sification of Lekholm & Zarb.15 D1 known as an inter- foramina area in which a careful diagnosis should be made due to the following procedure, bone den- sity is very high and the osteotomy drills could heat the bone, irrigation temperature could facilitate healing response, dullness of the drills during osteo- tomy should be counted for, tap drills are required, arterial supply in the symphasis area should be con- sidered and this area is utilised as a donor site for the chin (symphyseal) block bone graft. D1 includes six © rommma/Shutterstock.com 32016

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