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Bone Grafting Assessment: Focus on the Anterior and Posterior Maxilla Utilizing Advanced 3-D Imaging Technologies Bone Grafting Assessment: Focus on the Anterior and Posterior Maxilla Utilizing Advanced 3-D Imaging Technologies

Author(s):

Scott D. Ganz, DMD

Date Added:

1/9/2012


Summary:

As dental implant reconstruction has evolved into a mainstream alternative to replace missing teeth, bone grafting techniques have also evolved as an ancillary procedure for site development, sinus augmentation, and guided bone regeneration. Concurrently, imaging technologies have been developed which allow unsurpassed inspection of the dental alveolar complex, providing clinicians with innovative tools to plan for dental implant reconstruction. The ability to diagnose and treat dental implants have been forever changed by the ability to assess patient anatomy using Computed Tomography (CT), Cone Beam (CBCT), and interactive treatment planning software within the universal standard "language" of data called DICOM (Digital Imaging and Communications in Medicine). This increased ability has been expanded to include appraisal of bone grafting receptor and donor sites through innovations in the interpretation of three dimensional data. In the completely edentulous mandible or maxilla, the use of CBCT technology is an essential tool for assessing anatomy in preparation for implants or grafting. The ability to visualize the extent of a defect from various angles, views, and 3-D reconstructions has helped to define a new set of diagnostic paradigms. A two-dimensional panoramic reconstruction of the maxilla can provide a good scout film of the anatomy; however, as a two-dimensional modality, it has inherent limitations and distortion. The right and left maxillary alveolar bone height can be approximated, and the relative size of the bilateral maxillary sinuses or extent of pnuematization can be assessed in relation to the underlying bone and nasal cavity. However, it is not until all possible two-dimensional and 3D views have been examined that the actual bone anatomy can be appreciated and assessed in relation to the planned reconstruction.

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