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ePaper created 2017-08-25, 17:58:13 | version 1.38.0
| cone beam supplement use of CBCT Optimal treatment planning for perfect aesthetic and functional results—case report Author: Dr Cosmin Dima, Romania Introduction When the patient first presented to my clinic, she was 16 years old, came with a major dental trauma caused by a bicycle accident a few years before. As a result of the accident, she lost one of the central incisors and the other one was fractured. The patient was desperate about her smile, she wanted it back and she had very high aesthetic expec- tations, I knew then that this case would be a challenge. I thought to myself: ‘Am I capable to give her back her beautiful smile? And more than this, am I capable to give her beautiful smile back for the rest of her life?’ This means maybe for the next 60 to 70 or even more years. As dental professionals, we want to give to our pa- tients’ long-life and predictable results of the treat- ment; however it is very hard with young patients who are still growing. Therefore, I decided to postpone the surgery until she was at least 18 years old, and we decided to proceed with a temporary aesthetic resto- ration and to keep the patient under constant dental control over the next two years. Finally, we decided to make a permanent prosthetic restoration; taking into consideration the high aes- thetic requirements of the patient and her young age, I chose implant treatment. Treatment planning After a clinical examination,a cone beam comput- erised tomographic (CBCT) scan was performed (VGi evo, NewTom). Nowadays, inserting an implant without using a CBCT is like driving to an unknown destination without GPS, but still hoping to arrive at the right place only because you are a good driver. You could succeed by mistake or being lucky, but a risk of a failure is too high. During a clinical examination, I observed a horizon- tal and vertical bone defect (Figs. 1a–c) but did not expect any complications. In many cases, the crest looks fine during the clini- cal examination, but after raising the flap it appears that the bone is much thinner than expected because Fig. 1a Fig. 1b Fig. 1c 46 CAD/CAM 3 2017