In a previous article “Two Fundamental Steps For Implant Planning”, I spoke about implant planning and the need for both proper placement and of course sufficient tissue surrounding any implants.
With the increased use and availability of CBCT it's easier than ever to know just how much bone is present prior to surgery systems and just where an implant can be placed.
One risk that exists with the increased use of CBCT scans is we could find ourselves tempted to place an implant on a particular location based on the fact that there is plenty of bone.
However, it's vital to remember that the restorability of the implant is just as necessary as it being surrounded properly by tissue. It's important to not only have our implants surrounded properly by tissue, they must also be placed in a position to facilitate the planned restoration.
One of the great features in particular of a system such as the GALILEOS is it can aid you in not only evaluating the amount of bone present but also how the implant you are proposing fits into your restorative plan. In a very simple case of a single posterior implant you could use the adjacent teeth to judge if your proposed placement will allow for proper restoration.
If the case is more complicated, a radiopaque template of the proposed restoration can be placed in the patient's mouth during the scan allowing you to visualize the proposed restoration in the scan. I use both a GALILEOS and a CEREC unit and can even overlay the proposed restoration from the CEREC unit on the CBCT scan rather than having to scan the patient with a radiopaque mock up at the time of the scan. This allows for optimal visualization of the proposed implant and restoration.
While CBCT technology is of tremendous value in implant dentistry, it's important to remember these scans still expose our patients to radiation and therefore should only be used when indicated and not simply in cases for which there is not a need or indication.
John R. Carson, DDS, PC, Spear Visiting Faculty. [ www.johnrcarsondds.com ]