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Case Overview

This patient is a 65-year-old healthy Caucasian emale. She presented to us in July2009 with recurrent caries under an existing PFM on #4. A periapical lesion waspresent extending to the foor o the sinus. The tooth was deemed unrestorable

due to caries extending deep into the post space. The tooth was extracted withperiotomes and luxating elevators, and careul rotational movement, attemptingto spare the thin buccal plate. The socket was debrided, inspected or buccal bonedamage and repaired using an intrasocket Type I collagen membrane1 and solventpreserved mineralized cancellous allograt2. The membrane was closed over thesocket and tucked under the palatal fap.

CLINICAL CASE

KODAK 9000 3D Extraoral Imaging System

Focused-Field CBCT or

Evaluation o Socket Prior to

Implant Placement

Joel B. Henriod, DDS MHS

Pasadena, CA

Dr. Joel B. Henriod graduaterom UCLA School o Dentiin 2006. He received hisPeriodontics specialty certifand Masters in HealthScience in 2009 rom MedicUniversity o South CarolinaHe practices in Pasadena, CHe ocuses his practice oncontemporary periodonticsemphasizing regenerativetherapy, minimally invasivetissue grating, advanceddental radiology, and dentaimplants. Dr. Henriod prese

dozens o CE courses each to dentists and hygienists. Hdeveloped Dental School ia Day, an interactive trainiprogram or dental sales teaDr. Henriod belongs to varioorganizations: the AmericanAcademy o Periodontologythe ADA, the Caliornia DenAssociation, the CaliorniaSociety o Periodontists, andthe San Gabriel Valley DentSociety.

Recurrent caries under existing PFM on #4.

KODAK Product KODAK 9000 3D System

Post-extraction: the socket is repaired with a

Type I collagen membrane.

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Healing was uneventul, and the Kodak

9000 3D system was used or a pre-implantscan at 4 months. The CT scan revealedavorable bone density and volume orimplant placement. Exact measurementswere used to select an appropriate implant.

Interpretation o the rest o the volume

showed very thin buccal bone and rootdehiscence on adjacent roots, as well asexact sinus anatomy near the proposedimplant apex.

3D Guides the Treatment Decisions

CLINICAL CASE

KODAK 9000 3D Extraoral Imaging System

Axial slice reveals avorable bone density.

Coronal slice with exact measurements to select the appropriate implant.

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A tapered implant3 was placed according to

an acrylic surgical guide maintaining at least1.5 mm rom adjacent tooth to implant edge,with implant platorm placed 3-4 mm romthe proposed CEJ o the implant restoration.The implant site was ound to have goodbone density approaching D2. The implanttorqued greater than 35 NCM. A healingabutment was placed with 1 mm are andallowed to heal or 8 weeks.

At 8 weeks the healing abutment was

removed, and a fnal impression was takenater try-in abutments estimated potentialabutment options or the lab. A precontouredabutment was selected and a PFM wasabricated as the fnal restoration. The fnalrestoration was cemented ater torquing thefnal abutment to 32 NCM.

Sagittal slice with virtual implant placed. 3D volume with virtual implant placed.

PA image with implant placed.

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Carestream DentalCarestream Health, Inc. 2011.The Kodak trademark and trade dress are used under license from Kodak.1.Socket Repair Membrane. Zimmer Dental. Carlsbad, CA. 2.Puros Mineralized Cancellous Bone Graft 250-1000micron. Zimmer Dental. Carlsbad, CA. 3.Tapered Screw Vent Implant 4.1 x 11.5 mm. Zimmer Dental. Carlsbad, CA.

CLINICAL CASE

KODAK 9000 3D Extraoral Imaging System

Testimonial

This case presents the routine use of focused-field cone beam scans in our implant practice.

Due to high resolution, low radiation, and the ability to image the specific area of interest, we

employ CT scans at various timepoints in implant therapy: pre-bone graft, post-bone graft / pre-

implant, and during evaluation of peri-implantitis lesions. The advent of cone beam technology

is a natural and necessary in implant dentistry. Implant dentistry requires careful planning to

achieve long-term stability and biologic imitation. Three-dimensional radiology allows evaluation

of anatomy that is difficult or impossible to interpret from two dimensional radiographs.

Superimposition of structures, anatomic variations, and bone volume are critical to proper

implant planning, yet require extrapolation with traditional radiology. Seeing the true anatomy

present in each patient affords greater confidence in selecting bone graft techniques and final

implants for the conservative and careful implantologist.

Healing abutment with sutures. Final restoration cemented after torquing

the final abutment to 32 NCM.

For more information, contact your local authorised dealer, or visit us online at

www.carestreamdental.com.

http://www.carestreamdental.com/http://www.carestreamdental.com/http://www.carestreamdental.com/