Improved CBCT diagnostic acuity
Fig. 1: Duplication of a patient’s denture with a radiopaque material reveals the relationship between the desired tooth position and the underlying bone.
Fig. 2: A cross-sectional slice of a maxillary anterior incisor tooth, showing: the outline of the lip (yellow arrows), the root apex (red arrow), and the exposed tooth root (pink arrow).
Fig. 3: The lip rests against the maxillary canine alveolar-tooth-root complex (yellow arrow). If an implant osteotomy follows the tooth socket, it can potentially perforate the thin facial cortical plate (pink arrows).
Fig. 4a: A maxillary 3-D volume ‘clipped’ through the right canine tooth (marked in red) (a). The 3-D reconstructed volume helps to further define the maxillary alveolar anatomy, tooth, and root position within the bone (b).
Fig. 4b: A maxillary 3-D volume ‘clipped’ through the right canine tooth (marked in red) (a). The 3-D reconstructed volume helps to further define the maxillary alveolar anatomy, tooth, and root position within the bone (b).
Fig. 5: Software segmentation simulates a virtual extraction from the alveolus, illustrating the socket anatomy, the thin facial cortical plate (yellow arrows), and the palatal bone thickness (green arrow).
Fig. 6: The software allows each image to be enlarged for closer inspection.
Fig. 7: A simulated implant of the appropriate diameter and length can be positioned within the virtual socket illustrating: (a) thin facial cortical bone and (b) thicker palatal bone.
Fig. 8: Placing a cotton roll under the lip, as seen in the cross-sectional slice, brings the lip away from the tooth, root, and alveolus (yellow arrows); and defines the vestibule (red arrow).
Fig. 9a: An implant simulated with an abutment trajectory projecting through the clinical crown (green), perforating into the incisal canal.
Fig. 9b: For a screw-retained crown, the screw-access hole would need to project through the lingual/palatal aspect of the crown, dictating bone grafting to cover the exposed threads.
Fig. 10a: The ‘lip-lift’ clearly illustrates the advantages of placing a cotton roll in the labial vestibule (yellow arrows). The alveolus curves superiorly to the nasal floor (red arrow), and the soft tissue thickness revealed.
Fig. 10b: The outline of the simulated implant (green) and the yellow outline of the virtual tooth allows further inspection of the implant within the desired receptor site, and the thickness of the soft tissue (pink arrow).
Fig. 11: The ‘lip-lift’ technique helps to define the volume of bone required to fill the defect to achieve optimal results (yellow outline).
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