Various Imaging Modalities for the Investigation of Dental Implant –A Cross-Sectional Study

 

S. Mounika1*, Dr. Revathy Goundar2

1BDS Student,  Saveetha Dental college, 162 Poonamallee High  Road,Velappanchavadi,Chennai-600077

2Senior Lecturer, Dept. of Prosthodontics, Saveetha Dental college, 162 Poonamallee High  Road,Velappanchavadi,Chennai-600077

*Corresponding Author E-mail: mouni.s1508@gmail.com

 

ABSTRACT:

AIM: The aim of the study is to investigate the various types of imaging techniques  used in the dental implants.

OBJECTIVE: The study concentrates on the  analysis of various types of imagining techniques used in the dental implant cases. BACKGROUND :Dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth or bridge. Dental implants may be optional for people who have lost a tooth or teeth due to periodontal diseases,  an injury, or some other reasons. Implant imaging provides accurate and reliable  diagnostic information about the patient's proposed implant site.It includes intra oral and extra oral radiographs. REASON: To gain knowledge about the various imaging techniques used in the dental implant diagnosis and prognosis.

 

KEYWORDS: Dental implants, imaging , radiographs.

 

 


INTRODUCTION:

The use of dental implants has increased dramatically over the last decade and is becoming the preferred choice of replacing missing teeth over conventional fixed and removable prosthesis.

 

There are many factors that play a role in the success of implant dentistry. One key factor is pre-surgical assessment of the alveolar ridge as a potential site.

 

Radiographs can provide the most accurate means to assess the morphology of the alveolar ridge. There are several imaging modalities available to the clinician. Several imaging objectives should enable the clinician to best select the ideal radiographic system [1].

 

Intraoral periapical radiographs, are made using paralleling technique[ 2] Periapical radiography used to rule out the presence of pathosis, location of anatomic structures in relation to implant site [3]. It also determines vertical height, architecture and bone quality [density, amount of cortical bone and amount of trabecular bone] [4] . Panoramic radiographs are used for the longitudinal assessment of the success of the implant. They are also used to assess the crestal alveolar bone and cortical boundaries of the mandibular canal, maxillary sinus and nasal fossa. Cephalometric radiographs with lateral, posteroanterior and oblique views of the jaws will provide information about critical structures such as the floor of nasal cavity, the anterior recess of maxillary sinus and the nasal palatine canal [5].

 

Cone beam CT is a relatively newer modality, specifically designed for maxillofacial imaging introduced in the late 1990s. It gives all the information of CT at 1/8th the radiation dose, detection of canals and at a lower cost [6]. CT  was  first  applied  successfully  in implantology  in  the  1980s  [7]  In  CT  implant imaging,  multiple  thin  axial  slices  are obtained  through  jaws  and  then  the  data  are reformatted  with  special  software  packages to  produce  cross-sectional  and  panoramic views.[6]

 

The  importance   of  imaging  the  implant site  is  to  decide  whether  implant  treatment is  appropriate  for  the  patient,  to  know  the location  of  vital  anatomical  structures  such as  the  inferior  alveolar  nerve  and  the extension  of  maxillary  sinus,  for  the assessment  of  bone  quantity,  such  as  the height  of  alveolar  process,  the  bucco-lingual width,  angulation,  and  the  detection  of possible  undercuts  and  concavities,  to identify  any  possible  pathological  conditions, to  estimate  the  length  and  width  of  the implant  to  be  inserted,  the  appropriate number  of  implants,  the  location  and orientation,  and  the  possible  need  for additional treatment before implant placement,  for  instance  bone  augmentation procedures  and  to  estimate  the  prognosis [8-12]. The purpose of this study is to evaluate, determine the most efficient, patient’s comfort ability, easy to use  among different type of radiograph.

 

MATERIALS AND METHOD:

The study was conducted among the 120 dental  students and dentists in  Tamil Nadu during the month of April. A questionnaire consisting of fourteen questions with imaging options such as IOPA, PANORAMIC, LATERAL CEPH, CBCT and other types of radiographs.  The questionnaire had distinct sections like  diagnosis of pre prosthetic implants , post prosthetic implants , sectional diagnosis, cost efficiency , imaging quality etc. Finally statistical analysis was done  separately for each type of radiograph.

 


 

RESULTS:

 

Fig:1

 

 

Fig:2

 

Table:1

CRITERIA

IOPA

PANORAMIC

LATERAL CEPH

CBCT

OTHERS

Pre prosthetic

55%

50%

23%

42%

25%

Post prosthetic

47%

10%

40%

38%

30%

Surgical

50%

5%

5%

32%

34%

Full arch

29%

23%

0%

73%

8%

Sectional

43%

30%

75%

12%

24%

Asses sinus

31%

27%

35%

32%

60%

Lesser radiation

20%

24%

78%

29%

10%

Cost efficient

42%

43%

70%

38%

45%

Ease in use

33%

30%

50%

30%

48%

Poor image

11%

45%

48%

25%

40%

Accurate-measurement

42%

37%

27%

55%

28%

Superimposition

45%

5%

60%

31%

40%

Opposite structure

47%

56%

45%

53%

45%

Mandibular canals

47%

13%

55%

58%

65%

 


Among the various types of radiographs the most commonly used types are  IOPA, PANORAMIC, LATERAL CEPH, CBCT   Others include CT. IOPA is widely used in pre prosthetic(55%), surgical intervention (50%). PANORAMIC is used for determining opposing structures(56%). LATERAL CEPH is mostly used in sectional (75%), it is cost efficient (70%), superimposition (60%)and in mandibular canal detection (55%). CBCT is used in full arch detection (73%), accurate measurement (55%), opposite structure (53%) and mandibular canal detection (58%).  Other type of radiographs like CT is used extensively for the assessment of sinus (60%).

 

DISCUSSION:

The selection of proper imaging modality  is based on the advantages , disadvantages and the radiation dose. Many types of radiographic imaging techniques  such as intra oral, panoramic, cephalometric which are used in the initial stages of diagnosis and once when the particular site  is selected for implant placement the it involves the use of  other types of radiographs such as computed tomography.  

 

Pre prosthetic diagnostic radiographs are important because they help in site identification for the implant placement evaluation, treatment planning ,post prosthetic radiographs are used to check the integration of the implant. Full arch radiograph is used for the accurate implant planning. According to Hung et al. the  knowledge about the inferior alveolar nerve is important in cases of placement of implants in the mandible also the intraosseous  distribution of the inferior nerve is essential to be  diagnosed for the implant placements. In cases of atropic mandible implant is placed after increasing of the bone level above the  canal by grafting or by lateralization. Assessing the sinus is also important because exposure of the implant into the sinus or perforation of the membrane may lead to the failure of the implant. According to Urdaneta et al . the alveolar crest ridge dimension aids in the stability of the implants. According to Binke Chen et al.  the  presence of pathogens should be checked  because it may lead to peri implantitis. Peri implantitis occurs due to  array of periodontal pathogens that are found around the failing implants. The opposing occlusal plane should also be checked for its stability and support for the implant placement.

 

CONCLUSION:

With the improved imaging methods that exist in the present should used properly used. Selection criteria should be made such that it satisfies the dentist by providing the proper details required.

 

REFERENCES:

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10.           Bahat  O.  Treatment  planning  and placement  of  implants  in  the  posterior maxillae:  report  of  732  consecutive Nobel Pharma  implants.  Int  J  Oral Maxillofac  Implants.  1993;  8:151-61.

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Received on 24.07.2016             Modified on 02.08.2016

Accepted on 09.08.2016           © RJPT All right reserved

Research J. Pharm. and Tech 2016; 9(11): 1930-1932

DOI: 10.5958/0974-360X.2016.00395.4