Do I need a 3D CBCT image before a dental implant?

Dental implants may be an excellent solution for replacing single or multiple teeth. Your dental surgeon may have suggested a three dimensional (3D) cone beam computerized tomography (CBCT) image prior to your surgery. Why is that?

Dental implants are placed into your jaw bone, either the upper (maxilla) or lower (mandible) where the cells in your bone are attracted to the specially treated surface of the implant and grow around it in a process called osseointegration.

Traditional 2D radiographs or x-rays are not sufficient to calculate the volume of jaw bone available at the proposed implant site. Remember the body is a 3D structure therefore a 3D image is required. Your surgeon will be able to precisely measure both the width and depth of a proposed site and determine whether bone grafting is required prior or during implant placement and what size (diameter and length) of implant is best suited to that site for the best clinical outcome. You may have to go to an external imaging centre but here at Mosman Dental Surgery we have a brand new in office imaging machine for patient ease and convenience.

There are also vital anatomical structures in the jaw bones that need to be carefully and precisely avoided. There is a nerve in the lower jaw that provides sensation to the lip, chin and tongue. Implant drills or implants themselves can irreparably damage this nerve leading to permanent altered sensation if accurate measurements are not taken from a 3D CBCT image.

In the upper jaw the roots of posterior teeth lie very close to the floor of the maxillary sinus. When these teeth are missing the body resorbs away the bone leaving the sinus floor to drop down closer to the mouth. Careful consideration and accurate measurements from a 3D CBCT image are required for a successful outcome.

Your surgeon may also elect to perform a guided implant surgery for more accurate preparation of the osteotomy (hole in the bone) and placement of the implant. Your surgeon will use your 3D CBCT and implant planning software to accurately plan your surgery to within 1/10^th of a millimetre and use this plan to fabricate a customized surgical guide.

Dental implants can be a great solution to restoring your mouth but careful planning in the preliminary stages will greatly increase your chances of a successful outcome and a large part of that  planning is done using a 3D CBCT image.