Usage of CBCT diagnostics in implant - prosthodontic treatment planning

Sanacija djelomične i potpune bezubosti oduvijek se smatrala jednim od temeljnih aspekata u dentalnoj medicini. U današnje vrijeme, zahvaljujući razvitku dentalne implantologije, implantoprotetska terapija zauzima prvo mjesto na ljestvici rješenja u vidu nadoknade izgubljenih zubi. Razvitkom tehnologije u zadnjih nekoliko desetljeća cone beam računalna tomografija (CBCT) našla je svoje mjesto u dentalnoj medicini. Trodimenzionalne snimke koje daje sve se više koriste u svakodnevnom kliničkom radu, osobito na području oralne kirurgije koja je, kad je implantoprotetska terapija u pitanju, u bliskom odnosu sa stomatološkom protetikom. Za razliku od dvodimenzionalnih snimki, CBCT daje mogućnost precizne trodimenzionalne analize anatomskih i patoloških struktura, omogućuje mjerenja bitna za kirurške zahvate te svojom kompatibilnošću s drugim programima otvara opciju detaljnog planiranja i vizualizacije budućeg protetskog nadomjestka. Takav koncept danas se naziva protetski vođenom implantologijom. Osim u dijagnostici i planiranju, CBCT se kod računalno potpomognute implantacije koristi za izradu kirurških vodilica koje više nego ikad omogućuju preciznu implantaciju, smanjuju mogućnost nastanka komplikacija i povećavaju predvidljivost konačnog rezultata terapije. Osim tehničkih prednosti koje ova vrsta tehnologije donosi doktoru dentalne medicine, pridonosi i olakšanoj komunikaciji s pacijentima, a samim time povećava se obostrano zadovoljstvo cjelokupnim procesom izrade implantoprotetskog rada. Međutim, CBCT i njemu kompatibilni programi zahtijevaju određeni stupanj tehnološke obrazovanosti te dodatnu edukaciju liječnika, no mlađim generacijama to sve manje predstavlja problem te se upravo iz tog razloga 3D tehnologija sa svim svojim pogodnostima sve više inkoroporira u svakodnevnu kliničku praksu. Partial and complete edentulism treatment has always been considered as one of the main aspects of dentistry. Nowadays, thanks to the development of modern implant dentistry, implant prosthodontics takes first place on the scale of options for tooth loss rehabilitation. With the development of modern technology over the last few decades, cone beam computed tomography (CBCT) found its place in dentistry. Usage of three-dimensional images that it provides is increasing in everyday practice, especially in the field of oral surgery which, when talking about implant-prosthodontic treatment, is closely related to prosthodontics. Unlike twodimensional imaging, CBCT allows precise 3D analysis of anatomical and pathological structures, enables measurements crucial for surgical procedures and, being compatible with other software, gives the option of accurate planning and visualization of the future prosthodontic appliance. This concept is nowadays referred to as “prosthetically driven implantology”. Apart from diagnostics and treatment planning, CBCT can be used in computernavigated implant surgery for surgical guide fabrication. These guides allow utterly precise implantation, descreasing the risk of complications and increasing predictability of the final outcome. Besides the technical advantages that this type of technology provides for a dentist, it also facilitates communication with patients, which ultimately increases mutual satisfaction with the overall process of implant-prosthodontic treatment. However, CBCT and CBCT-compatible software require a certain level of technological familiarity and additional education of dentists, but younger generations seem to consider that less of a problem and that is one of the main reasons for increased incorporation of 3D technology, with all its benefits, into everyday practice in dentistry.