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International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 13 (2011), No. 3     15. Sep. 2011

Int Poster J Dent Oral Med 2011, Vol 13 No 3, Poster 546

Facing the facts: Cone beam CT imaging in diagnostic implant dentistry

Cone Beam Computed Tomography

Language: English

Dr. Priyanka Pahwa, Dr. Neha Yadav, Dr. Arundeep K Lamba, Dr. Farrukh Faraz,
Department Of Periodontics and Oral Implantology, Maulana Azad Institute of Dental Sciences, Delhi University, Delhi, India

21st October 2010
59th Annual Meeting of American Academy of Implant Dentistry, Oct 20th - 23rd 2010
Boston Marriott Copley Place,Boston, Massachusets, U.S.A


Cone beam computed tomography provides 3-D cross-sectional views and has a high value when considering the ratio between diagnostic potential, cost of study, and risk to the patient. It has proven to be an important tool for the clinicians to diagnose and plan their treatment.

Fig: 1: Image Acquisition & Reconstruction Fig: 2: Implant Planning
Fig: 3: Cephalometric Analysis Fig: 4: Orthodontic Planning
Fig: 5: Dento Maxillofacial Imaging Fig: 6: Jaw Pathologies
Fig: 7: Impacted Teeth Fig: 8: Periodontal Diseases
Fig: 9: TMJ Analysis

Material and Methods

A 30 year old male reported with history of trauma leading to loss of teeth #8, #9, #23, #24, #25 and #26. Two dimensional (IOPA, OPG) radiographic examination revealed a faint radiopacity in upper anterior region. Further, three dimensional CBCT was performed to view it more precisely.

Fig: 10: Axial Image Fig: 11: Saggital Image
Fig: 12: Coronal Image Fig: 13: Panoramic Image
Fig: 14: Lateral Cephalometric Image Fig: 15: Volumetric 3-D Representation
Fig: 16: Cross-Sectional Slice - 1 Fig: 17: Cross-Sectional Slice - 2
Fig: 18: Cross-Sectional Slice - 3 Fig: 19: Cross-Sectional Slice - 4
Fig: 20: Cross-Sectional Slice With Measurement - 1
Fig: 21: Cross-Sectional Slice With Measurement - 2


Cross sectional views of the desired region when explored, revealed a radiopacity depicting presence of two root fragments. Surgical exploration was performed and root remnants were removed. The cavity was filled with bovine origin alloplastic material containing hydroxyapatite with collagen (BioOss®). Uneventful healing was seen and radiographic evaluation was done to observe the uptake of graft material.

Fig: 22: Preoperative - Intraoral Fig: 23: Preoperative - IOPA
Fig: 24: Intraoperative - 1 Fig: 25: Intraoperative - 2
Fig: 26: Intraoperative - 3 Fig: 27: Intraoperative - 4
Fig: 28: Intraoperative - 5 Fig: 29: Intraoperative - 6
Fig: 30: Postoperative - Intraoral
Fig: 31: Postoperative - IOPA


Thus the case study demonstrates the diagnostic utility of CBCT in providing the vital information about the implant sites in trauma cases and thus improving the clinical success of endosseous implants. CBCT is indispensable in the evaluation of osseous structures when planning treatment for dental implants. It creates the opportunity for clinicians to acquire the highest quality of diagnostic images with an absorbed dose that is comparable to other dental surveys and less than a conventional CT. The large field of view and 3-D image set offered by CBCT helps in adequate assessment of the implant site. CBCT is the medium of the future, predicting success of implant dentistry.

Benefits of CBCT

• X-ray beam limitation
• Image accuracy
• Rapid scan time
• Dose reduction
• Reduce image artefact
• Display modes unique to maxillofacial imaging

Limitations of CBCT
• Image noise
• Poor soft tissue contrast


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  2. Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Investig. 2006;10:1-7.
  3. Schwartz-Arad D, Levin L. Post-traumatic use of dental implants to rehabilitate anterior maxillary teeth. Dent Traumatol. 2004;20:344-7.
  4. Hatcher DC, Dial C, Mayorga C. Cone beam CT for pre-surgical assessment of implant sites. J Calif Dent Assoc. 2003;31:825-33.
  5. Dixon DR, Morgan R, Hollender LG, Roberts FA, O'Neal RB. Clinical application of spiral tomography in anterior implant placement: case report. JPeriodontol.2002;73:1202-9.


CBCT: Cone-beam computed tomography
3D: 3 dimensional
IOPA: Intra oral peri apical
OPG: Orthopantogram
CT: Computed tomography

This Poster was submitted by Dr. Priyanka Pahwa.

Correspondence address:
Dr. Priyanka Pahwa
Department Of Periodontics and Oral Implantology
Maulana Azad Institute of Dental Sciences,
Delhi University
Delhi - 110002