-
0
Patient Assessment
- 0.1 Patient demand
- 0.2 Overarching considerations
- 0.3 Local history
- 0.4 Anatomical location
- 0.5 General patient history
-
0.6
Risk assessment & special high risk categories
- 5.1 Risk assessment & special high risk categories
- 5.2 age
- 5.3 Compliance
- 5.4 Smoking
- 5.5 Drug abuse
- 5.6 Recreational drugs and alcohol abuse
- 5.7 Parafunctions
- 5.8 Diabetes
- 5.9 Osteoporosis
- 5.10 Coagulation disorders and anticoagulant therapy
- 5.11 Steroids
- 5.12 Bisphosphonates
- 5.13 BRONJ / ARONJ
- 5.14 Radiotherapy
- 5.15 Risk factors
-
2
Treatment Options
- 2.1 Mucosally-supported
-
2.2
Implant-retained/supported, general
- 1.1 Prosthodontic options overview
- 1.2 Number of implants maxilla and mandible
- 1.3 Time to function
- 1.4 Submerged or non-submerged
- 1.5 Soft tissue management
- 1.6 Hard tissue management, mandible
- 1.7 Hard tissue management, maxilla
- 1.8 Need for grafting
- 1.9 Healed vs fresh extraction socket
- 1.10 Digital treatment planning protocols
- 2.3 Implant prosthetics - removable
-
2.4
Implant prosthetics - fixed
- 2.5 Comprehensive treatment concepts
-
3
Treatment Procedures
-
3.1
Surgical
-
3.2
Removable prosthetics
-
3.3
Fixed prosthetics
-
3.1
Surgical
- 4 Aftercare
CBCT
Key points
- CBCT offers decreased irradiation dose vs spiral CT scan
- Radiation dose dependent on mA and exposure time; not on voxel size
- Dimensional accuracy has been proven to be high
- Different hardwares offer variety of fields of view (such as 4 x 4 to 15 x 20 cm) according to the clinical indication
- Both 2D and 3D images can be obtained
- Hounsfield unit measurements not as reliable as on spiral CT
- Integrating a planned or existing prosthetic device in the images is unvaluable for treatment planning
CBCT Considerations
- Radiation source collimated at its source and then diverges into a fan shape to reach detectors. This results in a cone beam.
- Pixel (picture + element) is the smallest single component of a 2-D image, whereas a voxel is the smallest element in 3-D environment.
- Large fields of view (FOV) visualize both jaws and their relationship.
- Small FOVs offer detailed images of bone trabeculae and cortex.
- Grayscale values vary for specific tissues within the image and are not as reliable as in spiral CT.
- CBCT can detect clinically relevant structures which are not visible on panoramic/intra-oral radiographs, such as the incisor canal, lingual concavities and missing osseous cortex
- CBCT 2-D image, showing the mesial extension of the incisor canal
- The CBCT is essential for preoperative planning and CAD-CAM manufacturing of drill guides and/or prostheses
- Except for gray values, CBCT provides information as accurately or even better as spiral CT, with less radiation exposure and costs
Fig 2: NobelClinician software screenshot - a CBCT is essential for preoperative planning and CAD-CAM manufacturing of drill guides and/or prostheses.
