dental implant - copy

8/3/2019 Dental Implant - Copy

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IMPLANT IMAGING

FEBINSHALU N V

FINAL YEAR PART-1


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Dental implants are metal posts that

are surgically implanted in the jaw tosupport a fixed dental prosthesis


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1. Root form2. Blade form

3. Subperiosteal


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Diagnostic imaging and techniques help todevelop and implement a cohesive andcomprehensive treatment plan for the implantteam and the patient


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1. Preprosthetic implant imaging2. Surgical and interventional implant imaging

3. post prosthetic implant imaging


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1. To determine the quantity,quality andangulation of bone

2. To determine the relationship of criticalstructures to the prospective implant site

3. To determine the presence or absence ofdisease at the proposed implant site


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1. To evaluate the surgical site during andimmediately after surgery

2. Assist in the optimal position and orientationof dental implants

3. Evaluate healing and orientation of dentalimplants

4. Ensure that abutment position and

prosthesis fabrication are correct


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1. Evaluate the long-term maintenance ofimplant rigid fixation and function,includingcrestal bone leval around each implant

2. Evaluate the implant complex


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Stage of tretment Time(months) Radiograph

Treatmentplanning

-1 PA,pan,tomo,CT,ceph

surgery 0 PA,pan,tomo,CT,ceph

healing 0-3 PA,pan,tomo,CT,ceph

remodeling 4-12 PA,pan,

maintenance 13+ PA,pan,

complication Any time PA,pan,CT


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1. Periapical radiographyAdvantages

a) High resolution images

b) High yield modality for ruling out local boneor dental disease

c) Valuable in identifying critical structures


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Disadvantagesa. It provides only lateral view of jaw and no

cross sectional information

b. It may suffer from distortion andmagnification

c. It become impossible to make precisemeasurements of vertical height of the

alveolar process


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d. Burnout effects are common,making crestalbone loss evaluation difficult

e. It is of little value in determinig bone densityor mineralization

f. It is of little value in depicting the spatialrelationship between the vital structures andthe proposed implant site


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Advantages1. Reduce patient exposure to radiation

2. Incresed patient comfort

3. Instant results4. Elimination of inconvenience associatedwith

developing

5. Cost saving


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6.Images can be manipulated for thedesired contrast ,colorenhancement,inversion,rotation of the

image7.Distance measurement in 0.1mm

increment is possible

8.Pseudo three dimensional view

9.Images can be stored with in anelectronic device.


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Advantages1. Provides generalized information about bone

density

2. Standard occlusal film provides width of theinferior border of mandible.

3. Laterally exposed film shows the width ofthe bone in the midline


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Disadvantages1. Two dimensional

2. Oblique and distorted images of themandibular alveolus

3. Mandibular occlusal radiograph showswidest width of bone versus the width atcrest


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4.The spatial relationship between the criticalstructures and proposed implant site is lostwith this projection

5.The degree of mineralization of trabecularbone is not determined from this projection


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Advantages1. The lateral cephalometric radiograph is

useful because it demonstrates the geometryof the alveolus in the anterior region.

2. The width of bone in the symphyseal regionand the relationship between the buccalcortex and the roots of anterior teeth may be

demonstrated.


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3.Together with regional periapical radiographquantitative spatial information is available.

4.Lateral cephalogram also can help to evaluatea loss of vertical dimension,skeletal archinter-relationship,anterior crown/implantratio.

5.Used to evaluate profile alteration after

prosthodontic rehabilitation


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Disadvantages1. Not useful for demonstrating bone quality

2. Only demonstrates the cross sectional imageof the alveolus.


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Advantages1. Gross anatomy of the jaw and other related

pathologic findings could be evaluated.

2. Opposing landmarks are easily identified

3. The vertical height of the bone initially canbe assessed.

4. Easy procedure and speed.


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Disadvantages1. Magnification depending upon the anatomic

location,position of the patient the focus-object distance and the relative location ofthe rotation center of the x-ray system.

2. Uniform magnification of the structuresproduces images with distortion.


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3.Little use in depicting the spatial relationshipbetween anatomic structures and implantsite.

4.Maxillary anterior region is difficult toevaluate.

5.Does not demonstrated bone qualitymineralization

6.Resolution and sharpness is less.


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Advantages1. It was superior to panoromic radiography for

bone height determination and for locationof the mandibular canal

2. Use of tomography increases the efficacy ofperiapical/panoramic images to predict theappropriate implant size.

3. Less cost than CT4. Less radiation exposure


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Disadvantages1. Not useful in determining bone quality or

identifying dental or bone diseases.

2. Image blurring and magnification error caneffect the accuracy of measurements.

3. Accurate localization of critical structures issometime not possible.

4. Anatomic variation may result in imagesthat are difficult to interpret.


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Advantages1. It produce very high resolution images.

2. With software programes,shows threedimensional images .

3. The use of CT splint with barium sulfate andmethyl methacrylate in the tooth portion,permits the implant team to evaluate

proposed tooth position ,abutment selectionand implant placement.


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4.Position of critical structures can beaccurately assessed.

5.It is helpful in patient education andmotivation


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Disadvantages1. High radiation factor

2. Resolution is less than spiral tomograms

3.

Expensive and time consuming procedure


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Advantages1. Ionization radiation is not used

2. No adverse effect have been demonstrated

3.

High resolution images4. Images can be reconstructed in all planes

without reformatting


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5.Excellent differentiation is possible betweendifferent soft tissues and between normal andabnormal tissues.

6.Intramedullary spread of pathology can be

determined

7.MRI visualizes the fat in the trabecular boneand differentiates the inferior alveolar canaland neurovascular bundle.


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Disadvantages1. Scanning time can be long

2. Contraindicated in patient with certainsurgical clips, cardiac pacemakers, firsttrimester pregnancy.

3. Equipment tends to be claustrophobic andnoisy

4. Metallic object should be removed


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5.Bone,teeth,air,metallic objects, all appearblack, making differentiation difficult

6.Estimate of bone quality may be problematic

7.Geometric distortion may arise when thehomogeneity of the applied magnetic field isdisturbed.


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1. Computer assisted implant imagingAdvantages

a) Highly accurate, with an error margin of lessthan 1mm

b) Injury to any critical structures is avoided


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Disadvantagesa) Pulse registration and the shifting of the

headgear will produce inaccurate results.

b) High radiation dosage CT scans limits its usefor navigation in oral surgery


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2.Periaical radiographyDisadvantage

a) Requirement of darkroom and 5 minutesdelay due to processing time required


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3.Panoramic radiographyDisadvantage

a) The patient must leave the surgical suite andstand or sit still for the procedure


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Periaical radiography Panoromic radiography

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