Cone Beam CT Scanning
(I-Cat)
Increases Versatility and Predictability of Implant Outcomes.
With the addition of our digital CT x-ray scanner, treatment planning for routine implant cases, extraction cases, and immediate-load cases are more predictable and therefore more successful. The cone beam technology adds a tremendous amount of information to the implant team. It provides a parameter of patient safety and keeps the implant team within the medical-legal standard of care. We can more accurately advise patients whether an implant or a bone graft is appropriate.
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Locating critical anatomy to avoid nerve injuries. In routine cases of replacement of posterior teeth, the I-Cat scanner provides a wealth of information regarding bone width and height. Even more important, the precise location of the mandibular nerve (Fig A) can be assessed in the detailed digital cross-sections (Fig B.) The addition of newer advanced software also allows us to highlight nerve locations. Precise software measuring tools and bone density tools can be utilized to select the appropriate size and type of implant that will fit within tenths of a millimeter above the mandibular nerve. In many cases this precise information allows us to avoid unnecessary bone grafting.
The I-Cat scanner can be used for post-op evaluation of sinus grafts and final restorations. The I-Cat scanner is an excellent tool for evaluating the details of the sinus floor and true cross-sectional anatomy. In these difficult restorative implant cases, patients who would previously be only candidates for removable prosthetics can be accurately evaluated for advanced grafting procedures with predictable outcomes. In addition, long term implant follow up evaluations can be done easily with the I-Cat. (Fig. C)
Virtual implant planning with immediate placement of full arch fixed provisional, “Teeth in an Hour.” Combining the technology of the I-Cat‘s precise dicom files with the highly accurate Nobel Guide software (Fig. D,) a two scan technique will allow specialized laboratories to fabricate a Cad/Cam surgical guide and an immediate fixed provisional . This advanced technology allows us to place the implants precisely and accurately. The implants can be placed in proper relation to the simulated fixed restoration (Fig. E.) Subsequently, the precision surgical guide (Fig. F) is used to fabricate the fixed provisional and place the implants. Immediately after removal of surgical guide the 12 unit fixed provisional is secured to the implants with prosthetic screws at the time of surgery (Fig. G, H, I.)
In summary, the I CAT scanner can be used for a variety of applications. Precise planning of routine cases, detailed evaluation of Implant sites, sinus anatomy, and nerve locations. Post operative implant evaluations are easily done as demonstrated in the sinus graft case above. In addition, there are other uses that are applicable. Orthodontic patient analysis, TMJ evaluations and airway evaluations are additional uses of this technology.
The I-Cat scanner is one of the most beneficial tools that has helped advance implant dentistry during the last decade.
Dr. Paul T. Akers
References:
1. Nobel Guide Procedures & Products manual
2. Use of “Virtual” Implant treatment planning: Inside Implant Dentistry, 6/08, pp 58-64, Orentlicher,
Goldsmith, Horowitz DMD.
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