Assessment of implant-related treatment with edited three-dimensional reconstructed images from cone beam computerized tomography : a technical note

Abstract

The development of dental implant-related treatments has led to the establishment of computerized tomography (CT) as an important tool for the 3-dimensional (3D) presurgical assessment of the dimensions of the available alveolar bone, and for locating important anatomic structures, such as the mandibular canal. Standard panoramic and periapical radiographs do not provide cross-sectional information and have therefore been considered insufficient for implant site evaluation. Studies on oral implantology have described the advent of CT methods to allow the professional to perform image-guided surgical planning and to fabricate a stereolithographic surgical guide. Conebeam computerized tomography (CBCT) units were developed for use in the maxillofacial area. Compared with other CT methods, CBCT offers advantages such as reduced effective radiation doses, shorter acquisition scan time, easier imaging, and lower costs. The use of CBCT devices provides high-quality 3D diagnostic reconstructed images of the maxillofacial region from the acquired data. It offers the advantage of analyzing the images by using multiplanar (MPR-CBCT, ie, cross-sectional and panoramic CBCT images) and 3D reconstructed (3D CBCT) images by volume rendering technique. These 3D CBCT images can be rotated in any spatial plane without superposition of the anatomic structures5 and have proven to offer complementary information for improving the implant placement surgical plan, commonly evaluated using only cross-sectional and panoramic CBCT views. However, we did not find any article in the literature review on the use of 3D CBCT images to evaluate the status of grafts and dental implants previously placed in jaws, in order to assess the tomographic follow-up of implant rehabilitation treatments and to perform a 3D evaluation of the sinus grafted area prior to implant placement in the posterior maxilla. Thus, this technical note is aimed at presenting a simple and accessible technique of editing 3D CBCT reconstructed images using an advanced opensource software, in a retrospective case series, to assess follow-up information on grafts and implant placement.