Computerized Tomography–based Imaging and Surgical Guidance in Oral Implantology
Computerized tomography (CT)-based imaging and surgical guidance carry both radiographic information such as height, density, and width of bone and clinical information such as axis of orientation for a successful prosthodontic result, thus determining the trajectory, depth, and distribution of the implants. The objective of this report is to review the associated literature and recent developments in CT-image–based information and surgical guidance systems. This report attempts to provide an argument for the development of evidence-based research on the utility of such systems and their effect on outcome in oral implantology.Abstract

A coned-beam computerized-tomography study performed with the i-CAT 3-D imaging technology (Imaging Sciences International, Hatfield, Pa). Images are shown in 2 dimensions: (A) panoramic slice and (B) cross sections or slices. Note the mandibular canal depicted in slices 45 to 65 and the mental foramen in slice 67. These cross sections correspond to the patient's lower right edentulous region

A coned-beam computerized-tomography study was performed with the i-CAT 3-D imaging technology (Imaging Sciences International) while the patient wore an imaging guide. The imaging guide was constructed with radiopaque restorative pins seen in (A) the panoramic slice and (B) the cross section. These pins represent optimal prosthetically driven access holes and trajectory for teeth 30 and 31. Residual bone trajectory and the mandibular canal were also used as guiding basics for implant trajectory, depth and length, and diameter. By utilizing ImplantMaster (I-Dent Ltd, Hod Hasharon, Israel), a 3-D reconstruction of a patient's anatomy was achieved and a surgical guidance template (C) was designed and computer manufactured with precise drilling-hole distribution and trajectory
Contributor Notes
Dov M. Almog, DMD, and L. Wolfgang, DDS, are clinical associate professors in the Department of Oral Diagnostic Sciences, University of Buffalo School of Dental Medicine, Buffalo, NY. Address correspondence to Dr Almog at 1960 Clinton Avenue South, Rochester, NY 14618 (dalmog@edgimplants.com).
B. W. Benson, DDS, MS, is a professor in Oral and Maxillofacial Radiology and N. L. Frederiksen, DDS, PhD, is a professor in the Department of Diagnostic Sciences, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas.
S. L. Brooks, DDS, MS, is a professor in the Department of Oral Medicine, Pathology, and Oncology, University of Michigan School of Dentistry, Ann Arbor.