Cone beam computerized tomography: basics for digital planning in oral surgery and implantology

For the diagnosis of bone pathology, planning of complex implant-supported prosthetic restorations, and guaranteeing oral surgery that is as safe and free of complications as possible, a three-dimensional radiological display is frequently indicated. Cone beam computed tomography (CBCT), which can cover a large part of the indications of the dental and oral surgical spectrum, represents an alternative to computed tomography. Moreover, the method offers the advantage that it can also be used in the dental practice, taking the existing radiation protection regulations into account. This guarantees optimum patient and user friendliness, because referral to a specialized CT facility is thus no longer necessary in most cases. In the first 12 months of the trials of the Planmeca Promax 3D at the Department of Dental Surgery and Radiology of the University Clinic for Oral and Maxillofacial Medicine in Graz, the overwhelming majority of referrals for CBCT (almost 90%) was concerned with the field of oral surgery and implantology. Oral surgical questions mainly covered aspects of wisdom tooth anatomy, position of impacted canines, premolars, and mesiodents, as well as cystic lesions. Diagnoses of the maxillary sinuses and the area of tooth preservation represented further indications. Apart from diagnostic purposes, the objective of the referrals was facilitating optimum preparation for the pending operation. In the area of implantology, this was combined frequently with pre- or post-augmentative three-dimensional digital therapy planning. CBCT showed good results in the display of hard tissue structures and can be integrated without difficulty in the daily clinical routine.