In recent years, the use of 3D technology in dental diagnostics and treatment planning has become a crucial step in dentistry, particularly in dental implantology. These technologies play an essential role in helping specialists accurately determine treatment strategies and even conduct virtual surgeries before actual procedures, significantly increasing the likelihood of success.
Dental implants have become a true lifesaver for many, eliminating the need for removable dentures, which often caused not only physical discomfort but also psychological distress. Moreover, in some cases, implants have made it possible to avoid bridge prosthetics, which required the devitalization of neighboring teeth to restore a single lost tooth. However, despite the broad possibilities, implants are not suitable for everyone. Some patients need to postpone surgery or undergo additional procedures to ensure successful implantation. Even when implantation is possible, it is crucial to select the correct implant length, angle, and depth of placement. 3D diagnostics, particularly a three-dimensional layered scan using cone-beam computed tomography (CBCT), can assist in this.
What does CBCT offer that other diagnostic methods do not?
The first thing CBCT diagnostics accomplishes is determining the necessity of implantation for a particular patient. The scan allows the dentist to see all missing teeth, identify problem areas, and decide on possible treatment options. The dentist may save a tooth and cap it with a crown or conclude that the tooth needs to be extracted and replaced with an implant. Thus, CT diagnostics provide comprehensive information about the indications for implantation.
The second significant advantage of 3D diagnostics is assessing the conditions for implantation. If there is enough bone tissue in the area of implantation and no other obstacles, the dentist can propose the earliest possible surgery date. In such cases, the patient only needs to undergo necessary tests, and the dentist prepares the appropriately sized implants. However, if there is insufficient bone tissue or other problems in the implant area, the surgeon can determine which preliminary interventions are necessary to create optimal conditions.
Today, there are many methods to address such issues, but without 3D scans, determining the treatment strategy can be extremely challenging. When the dentist decides on the method of implantation, it is important to measure not only the width and height of the bone tissue but also to consider the location of the mandibular canal, especially during lower jaw implantation. Nerve damage during surgery is unacceptable. If there is insufficient bone tissue, procedures like bone splitting, grafting, or even selecting a different implant site may be required.
Examples of CBCT use in dentistry
In upper jaw implantation, sinus lifting is often required. To do this, it is essential to know the condition of the maxillary sinuses, as this can influence the indications and contraindications for surgery. For example, if inflammation is found in the sinuses, the patient must first undergo treatment with an otolaryngologist before proceeding with implantation.
It is worth noting that the width and height of bone tissue cannot be accurately determined by touch or standard 2D imaging. This task is only within the capabilities of the CBCT device. For example, if a tooth has been missing for a long time and bone tissue has not formed in the socket area, this would not be visible on a 2D image. However, a 3D tomography scan can "see" beyond the dense cortical plate and determine what lies within.
Another important aspect of CBCT use is the ability to detect inflammatory processes in teeth adjacent to the planned implant site. If there is a cyst or granuloma near the implant site, the infection could spread to the artificial tooth, leading to its rejection. Therefore, it is crucial to examine not only the implant site but also the entire maxillofacial area and adjacent organs.
Age-specific considerations and challenges of implantation
Dental implantation is performed on both adolescents and the elderly. However, each age group has its own characteristics and challenges that must be considered when planning treatment.
Young people seeking a beautiful smile often opt for implants at the age of 17-18, especially if a tooth was lost due to injury or extraction. However, they may also face challenges, such as the need for bone grafting. Adolescents must undergo a special examination before implantation to determine whether their skeletal growth is complete. This is important because placing an implant during active growth could lead to changes in tooth positioning in the future.
In elderly patients, the main problems are related to age-related changes in bone tissue, which becomes more porous and less dense. In such cases, additional surgeries may be necessary to create conditions for implantation. Sometimes, the dentist may recommend alternative prosthetic methods if implantation involves high risks or requires overly complex interventions.
The history and development of CBCT
Interestingly, the CBCT device emerged after the era of implantation began. It was developed precisely because implant surgeons felt an urgent need for accurate bone tissue diagnostics. Before the advent of CBCT, surgeons performed operations "blindly," relying on their experience and tactile sensations.
Initially, new technologies did not generate much enthusiasm among dentists of other specializations since they had their diagnostic methods. However, over time, the advantages of CBCT became evident, and now this method is used in nearly all areas of dentistry.
The CBCT procedure: step by step
The CBCT procedure before implantation is conducted according to a standard protocol and does not require special preparation. Patients are asked to remove all metal objects from their head and neck to avoid distortions on the scan. The patient is then positioned correctly, bites down on a special bite block with their front teeth, and remains still for a few seconds while the scan is taken. The entire process takes only a few minutes and is comfortable.
After the scan is obtained, the dentist interprets it and begins planning the surgery. CBCT not only allows the current state of the oral cavity to be observed but also enables the modeling of the upcoming operation. Specialized software used in the CBCT machine allows a "virtual" implant to be placed in the intended position, assessing its placement and interaction with surrounding tissues. This helps to avoid potential complications, such as bone perforation or damage to adjacent teeth.
Postoperative monitoring and follow-up
After the surgery, the implant’s condition is monitored using 3D scans. This allows the dentist to assess the correct placement of the implant and its integration with the bone tissue. Previously, panoramic images were used for this, but they did not provide a complete picture. Nowadays, it is standard practice at Blanco Dentistry to perform 3D diagnostics immediately after surgery and, if necessary, a few months later to ensure successful healing and readiness for the next treatment stage—crown placement.
Conclusion
The use of 3D diagnostics in dentistry has become a vital step towards successful treatment. The CBCT device not only helps dentists accurately assess the condition of the oral cavity and plan treatment but also ensures patients that their health is in reliable hands. Modern technology makes dental implantation safer and more predictable, providing a high level of comfort and long-lasting results.
