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Maxillofacial imaging in implant treatment planning.pptx
- 1. Dr. Kaushik Dutta Reader Guru Nanak Institute of Dental Science and Research Consultant Maxillofacial Radiologist Eko X- ray and Imaging Institute Peerless Hospital and B.K. Roy research Institute Maa Durga Diagnostic Center Purvanchal Nagarik Samity Diagnostic Center Apollo Clinic, Barrakpur
- 4. Maxillofacial Radiography Conventional Intra- oral IOPA Bitewing Occlusal Extra- oral OPG Other skull imaging Advanced Contrast Radiograph y CT Ultrasonography MRI Nuclear Imaging
- 7. ? ? 1. Crestal changes
- 8. Advantages • Low Radiation • Good information • Easy to perform • Easy interpretation • Easy availability • Low cost Disadvantages • Inadequate sharpness • Technique sensitive • 2 D representation • Overlapping • Magnification • Partial information
- 9. Advanced Maxillofacial Imaging Cone Beam Computed Tomography Dental CT Imaging/ Dentascan
- 10. History • CBCT was first adapted for potential clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory. • The first CBCT system for DENTOMAXILLOFACIAL imaging in 2001 (Newtom QR Dvt 9000; Quantitative Radiology,Verona, Italy). • CT Introduced in 1972 By Godfrey Hounsfield
- 13. Planes of head and neck Sagittal Frontal/Coronal Axial
- 16. FOV FIELD OFVIEW SFOV SCACCING FIELD OFVIEW DFOV DISPLAYED FIELD OFVIEW
- 18. most CBCT units in comparison with CT is the able to reduce the FOV to the region of interest (ROI), either mechanically or electronically. CBCT systems can be categorized according to the available FOV or selected scan volume height as follows: • Localized region: Single tooth, Endodontic/ Periodontic evaluation • Single arch: Maxilla or mandible • Inter-arch: Maxilla & mandible • Maxillofacial: Mandible and extending to nasion • Craniofacial: From the lower border of the mandible to the vertex of the head
- 19. Reconstruction stage RAW IMAGES AXIAL CORONAL SAGITAL VOLUME RECONSTRUCTION MULTI- PLANER RECONSTRUCTION
- 20. Hounsfield unit
- 21. AXIAL IMAGE SCOUT CBCT DENTASCAN
- 22. PANORAMIC IMAGE SCOUT FOR CBCT
- 23. PANORAMIC SCOUT IMAGES IN DENTASCAN
- 25. Interpretation
- 28. READING CBCT IMAGES INSERTVIEWER CD. RUNVIEWER SOFTWARE.
- 29. TYPICAL CBCT DISPLAY INTERFACE AXIAL SECTIONS CORONAL SECTIONS SAGITTAL SECTIONS 3 D VOLOME RENDERIN G
- 30. CROSS-SECTIONS REFERRENCE AXIAL IMAGE PANORAMI C IMAGE CROSS SECTIONS Reference lines are marked to constantly guide us where we are exactly looking at.
- 31. Pre-surgical assessment Surgical and Intraoperative implant imaging Post prosthetic implant imaging
- 32. Assessment ofVital Structure (e.g. Floor of the Maxillary sinus, ID canal) Assessment of Dimension of the bone (e.g. Height and Width) Assessment of angulation of the long axis of the bone with vertical plane Assessment of the shape of the alveolar ridge Assessment of the quality of the bone (e.g. Bone Density) Implant Stimulation.
- 33. Evaluate the surgical site during and after surgery Assistance in the optimal position and orientation of dental implants To ensure that abutment position and prosthesis fabrication are correct.
- 34. Implant axis Final Relationship to vital structures Peri-implant bone Changes on adjacent crest of the dentoalveolar bone
- 35. Identification of the anatomical landmarks
- 39. Maxillary Sinus Crest of the alveolar bone
- 40. Floor of the maxillary sinus Floor of the nasal fossa Crest of the alveolar bone Buccal cortical plate Palatal cortical plate
- 42. ID canal Crest of the alveolar bone Mental foramen Inferior border of mandible
- 45. • ANGLE MEASUREMENTS • DISTANCE MEASUREMENTS • ANNOTATIONS • NERVE MARKERS • LABLES • IMPLANT SIMULATION TOOLBARS
- 46. Identification of the dimension of the alveolar bone
- 49. DILEMMA OF A RADIOLOGIST
- 50. CREST – RADIOLOGICAL/ CLINICAL
- 51. 12º sub-crestal angulation to match the natural tooth and root relationship and to overcome the anatomical constraints of the anterior maxilla
- 52. Identification of the angulation of the alveolar ridge Juodzbalys et al., JOURNAL OF ORAL & MAXILLOFACI AL RESEARCH
- 55. ASSESSMENT OF REPORT Cross- Section No. (distance between each cross section is 2mm) Distance From The Crest Of The Alveolar Bone To Respective Floor of the maxillary sinus/ nasal fossa. (In mm) Ridge Dimension Ridge Angulation (in respect to mid- sagittal plane) Implant Angulation** (in respect to mid- sagittal plane) Implant Dimension** (In mm) Implant System Used** Respec tive tooth region Distance From The Crest (In mm) Bicortical Distance (In mm) At crest NA NA Diameter of implant Length of implant NA Middle third Apical third
- 56. ASSESSMENT OF REPORT Cross Section No. (Distance between each cross-section is 2 mm) Distance From The Crest Of The Alveolar Bone To Respective ID Canal/ Inferior border of mandible. Ridge Dimension Ridge Angulation (in respect to mid- sagittal plane) Implant Angulation** (in respect to mid- sagittal plane) Implant Dimension** (in mm) Implant System Used** Respective tooth region. Distance From The Crest (in mm) Bicortical Distance (in mm) At crest NA NA NA NA Middle third Apical third
- 57. PROFORMAS FOR IMMEDIATE IMPLANT PLACEMENT Ridge Dimension Tooth dimension Dimension of surrounding cortical bone Distance From The Crest (in mm) Bicortical Distance (in mm) Width of the tooth root Bellow crest (in mm) Length of the tooth root Bellow crest (in mm) Buccal cortical bone thickness (in mm) Lingual cortical bone thickness (in mm) At crest NA NA NA NA NA Middle third NA NA NA NA Apical third NA NA NA NA
- 58. QUALITATIVE ASSESSMENT OF BONE Bone density
- 61. FUTURE APPLICATIONS CBCT ASSISTED IMPLANT PLACEMENT USING SURGICAL GUIDES.
- 62. PRE-OP IMPLANT PLANNING 3D PRINTING SURGICAL GUIDE
- 63. PROPER INTRA-ORAL PLACEMENT OFTHE GUIDE FLAPLESS OSTEOTOMY
- 64. RAISINGTHE FLAP AND IMPLANT PLACEMENT POST – OP CBCT SHOWING ACCURACY OF THE GUIDED SURGERY