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    How to place implants quickly and precisely using CBCT

    i-CAT imaging and related technologies facilitate the implant process from planning to placement.

    Implants are a much requested alternative to traditional bridges and partials in the dental practice. As implants become more sophisticated and adaptable to individual dental anatomy, dentists have greater opportunities for serving a wider patient base. Many technologies contribute to this popularity. The American Academy of Implant Dentistry (AAID) notes that “advanced, highly precise computer-guided dental implant surgery has made implant procedures faster, highly predicable and long-lasting with a success rate of 97 percent.” For my practice, CBCT (i-CAT™) and surgical guides make the process even more predictable.

    Case study

    When a member of my front office staff, Yari, confided in me that she had a toothache, I took a bitewing radiograph (DEXIS™ Platinum) and discovered that she had deep distal decay on tooth #20. Intraoral examination revealed a fracture beyond the cervical extent of the tooth (Fig. 1). The tooth was non-restorable, so she was facing extraction and had several choices about how to replace that tooth. We discussed the possibility of a removable partial denture, a fixed bridge, or an implant.

    Fig. 1Fig. 2

    Fig. 1                                                                                           Fig. 2

    Since she worked in the office each day, she said that after hearing my discussions with patients about cutting down healthy teeth and making a three-tooth problem instead of a one-tooth problem with conventional bridges, she wanted to have an implant.

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    To start the process, we took an i-CAT CBCT at 16cm x 11cm as a 0.25 voxel size (Fig. 2). I chose a full field of view size because Yari had some dental issues on the lower right-hand side to check as well, so I needed to have additional information on that area.

    I extracted the tooth and used autogenous platelet-rich fibrin (PRF) and bone graft to preserve the space. After the extraction, I allowed healing time (Fig. 3). Approximately four months later, we placed the implant.

    Fig. 3Fig. 4

    Fig. 3                                                                                                         Fig. 4

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    Christopher Hoffpauir, DDS
    Dr. Christopher Hoffpauir graduated magna cum laude from the University of Houston Clear Lake with a bachelor’s in biology with a focus ...


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