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 »  Home  »  Dental Implant 3  »  Computer Analysis of Titanium Implants in Atrophic Arch and Poor Quality Bone: A Case Report
Computer Analysis of Titanium Implants in Atrophic Arch and Poor Quality Bone: A Case Report
Results.

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RESULTS.
For better visualization of the images, it is more illustrative to use a pseudo-color scale. The different colors represent the different CT densities of the soft tissues and the bone tissue. Choosing pseudo-color imaging in the Hounsfield Scale, the different colors represent the following structures (note that within each hue, the luminance varies from dark to light) (Fig. 6):
  • White represents cortical bone, metal, and enamel.
  • Blue represents trabecular bone.
  • Green represents fat and muscle.
  • Yellow represents air
The cross-sectional images are the most informative slices for the evaluation of bone tissue and the examination of the anatomical structures near to the implant sites. Crosssectional images indicate a well corticalized mandible with resorbed alveolar ridge in the posterior areas and a poor corticalized maxilla with class IV bone. These images are evidence that all the implants are osseointegrated. SIM/Plant software allows for the visualization of the following images of the implant case presented:
  • Alignment image as an overall view of the skull and the arches with implants and supraconstruction (Fig. 7).
  • Axial images with the different axial slices of the maxilla and the mandible with implants and restorations (Figs. 8 and 9).
  • Panoramic images as a panoramic projection view of the maxilla and the mandible with implant and restorations (Figs. 10 and 11).
  • Cross-sectional images of the maxilla and the mandible with implants and supraconstruction.

Fig. 5. A radiograph of the implant-supported definitive restorations   four years after implantation.
Fig. 6. The Hounsfield Scale applying a pseudo-color scale.
Fig. 7. An alignment image as an overall view of the skull and the arches   with implants and definitive restorations.
Fig. 8. An axial image of the mandible with five titanium implants and   two natural teeth anchored in the cortical bone.

A radiograph of the implant-supported definitive restorations   four years after implantation

Mandible.
Slice in the area of 47. This is a cross-sectional view of the implant comprising the shaft and the basic disk. The shape is upside-down, and the disk is osseointegrated both outside and inside the cortical bone. Trabecular bone has formed around the center part of the disk. The mandibular nerve is just below the implant, and the residual bone height is 6 mm (Fig. 12). Cement has retained the crown of the implant bridgework on the abutment.
Slice in the area of 41. There is a double disk-design implant between the natural-tooth abutments in the interforaminal area, and the implant is osseointegrated in both cortical and trabecular bone (Fig. 13).
Slice in the area of 35. The monodisk-design implant is within 3 mm of the mental foramen, and the implant is completely osseointegrated.
Slice in the area of 37. The implant is placed in the posterior zone of the mandible, and the disk is osseointegrated both outside and inside the cortical bone. There is formation of trabecular bone around the implant. Cement has retained the implant restoration on the abutment, and the residual bone height relative to the mandibular nerve is _6 mm.

Maxilla.
Slice in the area of 17. A double disk-design implant was inserted in the floor of the right maxillary sinus after a sinus lift procedure. The Schneiderian membrane is clearly visible and lies on the basal disk. The disks are osseointegrated in the trabecular bone (Fig. 14).
Slice in the area of 15. The implant is laterally inserted with two disks ventral to the maxillary sinus. The nasal fossa and the hard palatine are also represented. The implant is osseointegrated. In this slice, the two disks (basal and crestal) are shaped like four circles (Fig. 15).
Slice in the area of 11. The laterally inserted implant is osseointegrated in trabecular bone, and the incisive canal is visualized.
Slice in the area of 25. The double disk-design implant is ventral to the left maxillary sinus. The implant is osseointegrated, and the implant shaft is visualized (Fig. 16).
Slice in the area of 27. There is an osseointegrated implant in the posterior zone of the maxilla after a sinus lift procedure. The space between the basal disk and Schneiderian membrane has been filled with hydroxyapatite.

Fig. 9. An axial image of the maxilla with five double disk-design implants.   Fig. 10. A panoramic image of the mandible that demonstrates a well-corticalized   mandible with implants, tooth roots, and supraconstruction.
Fig. 11. A panorama image of the maxilla that shows a poorly corticalized   maxilla and five double disk implants anchored in a class IV bone.
Fig. 12. A cross-sectional view of the implant that comprises the shaft   and the basal disk. It is shaped like an upside-down T. The disk is osseointegrated   in cortical and trabecular bone. Bridgework is cement-retained on the implant   abutment.
Fig. 13. A laterally inserted implant between natural-teeth abutments   with two disks. The implant is osseointegrated in cortical and trabecular bone.
Fig. 14. The double disk implant is placed in the floor of the right   maxillary sinus after a sinus lift procedure. The Schneiderian membrane lies   on the basal disk. The implant is osseointegrated in the trabecular bone.
Fig. 15. A titanium implant with two disks ventral to the maxillary sinus.   Hard palatine is visible. The implant is osseointegrated. The two disks are   shaped like four circles.
Fig. 16. A double disk implant ventral to the left maxillary sinus. The   implant is osseointegrated in the trabecular bone. The implant shaft is visualized.   .

A panoramic image of the mandible that demonstrates a well-corticalized mandiblewith implants, tooth roots, and supraconstruction