Name: How CBCT Can Improve Your Treatment Plan

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Imaging is a critically important aspect of diagnostics and treatment planning when placing dental implants.

High-quality, accurate images collected at the presurgical stage can yield dividends both in implant outcomes and patient satisfaction.

Traditional radiographic methods are not ideal for planning implant placement because you are visualizing a three-dimensional (3D) object in two dimensions and missing important information along the way.

The development of computed tomography (CT) allowed clinicians to take radiographic cross-sections, paving the way for 3D reconstructions of maxillofacial features, though this improvement came at the cost of higher radiation exposure.

CBCT is an advancement of the CT technology that uses a cone-shaped X-ray beam and a two-dimensional image receptor to generate high-quality 3D reconstructions with significantly lower radiation exposure. Because of these features, the Academy of Oral and Maxillofacial Radiology recommends this technique for presurgical assessments of implant sites.

This is in accordance with the ALARA (as low as reasonably achievable) principle – radiation exposure should be minimized to produce an image of the required spatial resolution and diagnostic quality.

New dimensions to the planning process
Gone are the days when clinicians had to rely on 2D implant-placement planning. Advances in technology have revolutionized the treatment planning workflow.

Clinicians can use 3D reconstructions, such as those based on CBCT scans, to better understand the situation they are correcting and create a prosthetic driven plan to optimize treatment for each individual patient.

One recent study compared treatment planning using panoramic radiography with the combination of panoramic radiography and CBCT. In that study, performing a CBCT scan during the implant planning phase increased the agreement in predicting implant length considerably, from 40% after the initial 2D scan to 69.5%.

An approach that comprises virtual treatment planning using CBCT followed by guided surgery has numerous benefits. In combination with the NobelClinician software and a guided surgery approach, CBCT allows clinicians to utilize flapless implant placement, which is less invasive and associated with high patient satisfaction, reduced patient discomfort and also improved soft tissue outcomes.

One way to incorporate CBCT into guided surgery planning is using the NobelClinician Software as part of the treatment plan workflow.

NobelClinician uses SmartFusion technology to combine CBCT reconstructions with scans of the intraoral situation to visualize the surgical area and tooth setup. This allows users to develop a treatment plan that maximizes the use of available bone at placement while also accounting for soft tissue features and prosthetic constraints, helping them produce the best possible results for every patient.

In summary, by incorporating CBCT into your workflow for planning guided surgeries, you can reduce the number of chairside decisions you have to make during surgery, improve your surgical outcomes and increase your patient satisfaction. Source: Nobel Biocare

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