This presentation deals with radiographic imaging of three important phases of implant placement; PHASE 1: PRE-PROSTHETIC IMPLANT IMAGING
PHASE 2: SURGICAL AND INTERVENTIONAL IMPLANT IMAGING
PHASE 3: POST-PROSTHETIC IMPLANT IMAGING
RADIOGRAPHIC IMAGING FOR DENTAL IMPLANT ASSESSMENT
1. PRESENTED BY:
DR. MONALI PRAJAPATI
PG PART III
UNDER GUIDANCE OF:
DR. JIGNA SHAH
PROFESSOR AND HOD
ORAL MEDICINE AND RADIOLOGY DEPARTMENT
GDCH, AHMEDABAD
2. In the present era when it comes to oral rehabilitation, a wide array of options are available
to restore the missing teeth using the fixed or removable prosthesis. The advent of implants
in the field of dentistry has given the dental professionals a viable option to provide the
patients with nearly a third set of dentition.
9. Bone Density Description Tactile Analog Typical Anatomical
Location
D1 Dense Cortical Oak or maple wood Anterior mandible
D2 Porous cortical and
coarse trabecular
White pine or spruce wood Anterior mandible
Posterior mandible
Anterior maxilla
D3 Porous cortical (thin) and
fine trabecular
Balsa wood Anterior maxilla
Posterior maxilla
Posterior mandible
D4 Fine trabecular Styrofoam Posterior maxilla
12. To decide if implant treatment is appropriate for the patient,
To detect any possible pathological conditions,
To ascertain height, buccolingual width, and angulation of
alveolar process,
To identify the location of vital anatomical structures such as
the inferior alveolar nerve and maxillary sinus,
To ascertain bone quantity,
To decide the length and width of the implant to be placed
19. Sites with acute infection
including exudate or pus flow are
considered high-risk, and can
cause post-surgical
complications if implants are
inserted in these infected sites.
28. FI NE TRABECULAR
PLATES AND MULTIPLE
SMALL TRABECULAR
SPACES
GENERALLY SHOWING LARGE
MARROW SPACES AND SPARSE
TRABECULATION
COARSER TRABECULAR
PLATES AND LARGER
MARROW SPACES
29. CRESTAL BONE LOSS EVALUATION CAN BE BENEFITTED USING
DIGITAL PERIAPICAL RADIOGRAPHY
32. The mandibular occlusal radiograph shows the
widest width of bone (i.e., the symphysis) versus the
width at the crest, which is where diagnostic
information is needed most .
33.
34. SPATIAL RELATION OF OCCLUSION
AND ESTHETICS
CROSS-SECTION OF CANINE AND
LATERAL INCISOR REGION
VERTICAL DIMENSION
RELATION OF LINGUAL PLATE WITH PATIENTS SKELETAL ANATOMY CAN BE
DETERMINED
(IMPLANTS ARE USUALLY PLACE ADJACENT TO LINGUAL PLATE IN ANTERIOR REGION)
43. (a)Cropped panoramic radiograph
demonstrating excellent bone height in
the lower right molar region. (b)
Reformatted cross-sectional CT images
showing reasonable bone height but the
ridge is narrow bucco-lingually.
44. CROSS SECTIONAL DIAGRAM
OF THE MANDIBLE
SHOWING THAT
STRUCTURES THAT ARE
MORE LINGUAL ARE
PROJECTED HIGHER ON THE
FILM THAN STRUCTURES
THAT ARE MORE BUCCAL
45.
46. DOES NOT DEMONSTRATE BONE
QUALITY
NO SPATIAL RELATIONSHIP BETWEEN
STRUCTURES CAN BE ESTABLISHED
55. EXPOSURE TIME – 36seconds
SINGLE EXPOSURE REQUIRED
LESS RADIATION EXPOSURE
EXPOSES BOTH ARCHES SIMULTANEOUSLY
LESS SCATTER
56.
57.
58.
59. If the facial wall is thin (≤ 1 mm), this bone will resorb
within 4 to 8 weeks leading to a horizontal, crater-
shaped bone defect and a loss of bone height on the
facial aspect.
60. EVALUATES THE
SURGICAL SITES
DURING AND
IMMEDIATELY
AFTER SURGERY
OPTIMAL
POSITIONIN
G AND
ORIENTATIO
N OF
DENTAL
IMPLANTS
TO
ASCERTAIN
THE HEALING
TO ENSURE
APPROPRIATE
ABUTMENT
POSITIONING
AND
PROSTHESIS
FABRICATION
63. EDGE ENHANCEMENT,” WHICH IS THE ABILITY TO DETECT SPACE
BETWEEN THE IMPLANT AND THE SURROUNDING BONE
ALLOW VIEWING OF ANY SUBTLE CHANGES IN BONE DENSITY
AROUND THE IMPLANT INTERFACE.
64. BONE LOSS AROUND A ROOT-
FORM DENTAL IMPLANT (THIN
RADIOLUCENT BAND
SURROUNDING THE IMPLANT),
INDICATING FAILURE OF
OSSEOUS INTEGRATION.
PERIAPICAL VIEW OF A
FRACTURED
ENDOSSEOUS IMPLANT.
65. A panoramic radiograph used for
postoperative assessment of multiple
successfully restored rootform implants.
66.
67. The cross-sectional reformatted CBCT images reveal nonrestorable ectopic
placement of the existing implants with lingual cortical perforation and extension
into the lingual tissues.
69. CLOSE
APPOSITION OF
THE BONE TO THE
SURFACE OF
EACH IMPLANT.
MINOR AMOUNT OF SAUCERIZATION IS PRESENT AT THE
ALVEOLAR CREST ADJACENT TO THE DISTAL FIXTURE
73. FACTORS TWO DIMENSIONAL
IMAGING
THREE DIMENSIONAL
IMAGING
MESIODISTAL WIDTH ASSESSED ASSESSED
BUCCOLINGUAL WIDTH NOT ASSESSED ASSESSED
VERTICAL HEIGHT ASSESSED ASSESSED
SPATIAL RELATION WITH
ANATOMIC STRUCTURE
NOT ASSESED ASSESSED
RADIATION LESS MORE
MAGNIFICATION MORE LESS
AVAILABITY AND
CONVENIENCE
EASY, CONVENIENT DIFFICULT
BONE DENSITY CAN NOT BE EVALUATED CAN BE EVALUATED
74. PERIAPICAL RADIOGRAPHY
ADVANTAGES DISADVANTAGES INDICATIONS
• Low radiation dose
• Minimal magnification
with proper technique
• High resolution
• Inexpensive
• Distortion and magnification
• Minimal site evaluation
• Difficulty in film placement
• Lack of cross-sectional imaging
• Bucco-lingual width can not be
measured
• Spatial relation can not be
established
• Bone density can not be
evaluated
• Single implant site
(anterior, middle,
posterior
maxilla/mandible)
• Alignment and
orientation during
surgery
(interventional
phase)
• Post- prosthetic stage
evaluation
75. OCCLUSAL RADIOGRAPHY
ADVANTAGES DISADVANTAGES INDICATIONS
• Low radiation dose
• High resolution
• Inexpensive
• spatial relation can not be
established
• Bone density can not be
evaluated
Of little value
CEPHALOMETERIC IMAGING
• Height / width in
anterior region
• Low magnification
• Skeletal relationship
• Crown/ implant ratio
in anterior region
• Relation of lingual
cortical plate to
skeletal structure can
be established
• Availability
• Image information limited to
midline
• Reduced resolution
• Single implant site
evaluation
• Anterior
maxilla/mandible
region
• Symphysis bone graft
evaluation
76. PANORAMIC RADIOGRAPHY
ADVANTAGES DISADVANTAGES INDICATIONS
• Single image of maxilla
and mandible
obtained
• Convenience, ease,
and speed in
performance
• Distortion and magnification
• Lack of cross-sectional imaging
• Bucco-lingual width can not be
measured
• Spatial relation can not be
established
• Bone density can not be
evaluated
• Single implant site
(middle, posterior
maxilla/mandible)
• Multiple implant site
• Implant overdenture
site
• Alignment and
orientation during
surgery
(interventional
phase)
• Post- prosthetic
stage evaluation
77. DENTASCAN/ CBCT
ADVANTAGES DISADVANTAGES INDICATIONS
• Negligible
magnification
• High contrast
• Axial, coronal sagittal
views
• Buccolingial width
determined
• Spatial relation can be
established
• Interactive treatment
planning
• High radiation exposure
• Cost
• Technique sensitive
• Single implant site (anterior,
middle, posterior
maxilla/mandible)
• Multiple implant site
• Implant overdenture site
• Unless any complication, not
advisable for interventional
and post prosthetic
evaluation
• Bone density
78.
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