3D Imaging and Dentistry

3D Imaging and Dentistry

From Multiplanar Cephalometry to Guided Navigation in Implantology

Three-dimensional (3D) digital radiology has given clinicians the opportunity to perform diagnoses and to plan treatments in dentistry and maxillofacial surgery with greater awareness and accuracy than with conventional two-dimensional radiology. The use of the third dimension and the feasibility of reconstructing the volume of a skeletal area under investigation has opened new frontiers, not only in diagnosis and treatment, but also in education, allowing one to computer-simulate the steps of future surgical procedures.

This textbook aims to provide basic information in volumetric radiology, which is necessary for its correct and rational use, following well-defined internationally acknowledged protocols. The various chapters outline the indications for prescribing 3D scans and explain the wealth of information available from proper image processing. There is a clear and synthetic overview of all dental fields in which cone beam computed tomography (CBCT) can be applied, from orthodontics to implantology, periodontology, endodontics, and temporomandibular disorders, so as to provide the reader with useful guidance in clinical practice.

Great attention has been devoted to the quality of images so as to reproduce as truly as possible the resolution of radiologic images obtained by using dedicated software to process Digital Imaging and Communication in Medicine (DICOM) files. This is an important aspect, as the reader can understand how the use of DICOM files is closely linked to the application of technical processing tools from simple viewers to more complex software products. Starting from DICOM files, images are processed and used for planning treatment as it happens in 3D cephalometry, in programming osteotomy procedures, and in guided implant surgery.

A considerable part of the textbook is devoted to cephalometric diagnostics and the outlining of a new approach in the anthropometric and esthetic analysis. 3D cephalometry is made possible because of the in-depth knowledge of the anatomy provided by 3D radiologic scans. The textbook also includes an anatomical-radiologic atlas with detailed points in bones and soft tissues so as to develop a cephalometric project.

Broad space has been given to investigating the anatomy of the airways for clinical applications: a section describes the structure of the maxillary sinus and its relation to clinical surgery. An extensive chapter covers implant planning and guided surgery, themes that are very topical and of great clinical interest.

This publishing project reconciles the objectives of a textbook for students and a valuable tool for continuous education of professionals with clinical experience. I hope this book can be a useful educational tool, helping clinicians to better treat their patients after they have been entrusted with their oral health.

Authors
Giovanna Perrotti, DMD, is head of the Orthodontics and Children's Dentistry Unit at IRCCS Istituto Ortopedico Galeazzi in Milan, Italy. She teaches advanced courses on oral implantology as well as contemporary rehabilitation and reconstructive jaw therapy at the University of Milan. Dr Perrotti has a degree in dentistry and dental prosthetics with a specialization in orthognatodontics. Author of scientific papers on orthodontics and dental diagnostics, she is a member of the editorial boards of Quintessenza Internazionale, International Journal of Oral & Maxillofacial Implants, Dental Cadmos, and CAD-CAM Digital Dentistry and is the coauthor of two multimedia collections for Med Tutor Odontoiatria (Utet Scienze Mediche, 2008 and 2014).

Prof Tiziano Testori, MD, DDS, FICD, is a fellow in oral and implant surgery at the University of Miami, as well as professor at the Faculty of Dentistry and Dental Prosthetics and head of the Implantology and Oral Rehabilitation Unit at the Dental Clinic in the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy. He received both his degree in medicine (1981) and his PhDs in odontostomatology (1984) and orthognatodontics (1986) from the University of Milan. From 2007 to 2008, Dr Testori was the president of SICOI and has since remained an active member as well as a member of the European Board of Oral Surgery (EFOSS). He serves on the editorial boards for the European Journal of Oral Implantology, International Journal of Oral and Maxillofacial Implants, and the International Journal of Periodontics and Restorative Dentistry and is the author of several books and 92 papers indexed in PubMed.

Dr Massimiliano Politi, DMD, is an attending physician at the Orthognatodontics Unit of the Dental Clinic of the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy and is completing a PhD in orthodontics from the University of Milan. Dr Politi devotes most of his time to research in the field of 3D diagnostics and maintains a private practice limited to orthodontics.


Co-Authors: Francesca Bianchi • Massimo del Fabbro • Giulia Ferrara • Silvia Ferrario • Luca Fumagalli • Fabio Galli • Francesco Grecchi • Giuliana Lorè • Mario Mantovani • Joanna Katarzyna Nowakowska • Andrea Parenti • Lorenzo Pignataro • Grazia Pozzi • Marco Scarpelli • Silvio Tascheri • Alberto Zerbi

Contents

Chapter 01. Basic Principles for the Use of CBCT in Dentistry
• Principles of Digital Radiology
• Computed Tomography
• Image Postprocessing

Chapter 02. Changes in Basal Bones from Infancy to Senescence
• Growth and Development of Facial Bones in 3D Images
• Theories on Control of Craniofacial Growth
• Bone Resorption and Atrophy of the Basal Bone
• Implant Therapy and Craniofacial Growth

Chapter 03. Systematic CBCT Analysis of the Maxilla and Mandible
• Radiologic and Clinical Anatomy of the Maxilla
• Radiologic and Clinical Anatomy of the Mandible
• Clinical Examples

Chapter 04. Evolution of Cephalometry
• Concepts of Cephalometry
• Dysgnathic Presentations in 3D

Chapter 05. Atlas of Cephalometric Landmarks
• Introduction to Cephalometry
• Atlas of Skeletal Landmarks
• Atlas of Soft Tissue Landmarks

Chapter 06. 3D Analysis of Soft Tissues
• Esthetic Analysis of Soft Tissues Using 3D Cephalometry
• Diagnostic 3D Analysis of Soft Tissues with Multiplanar Cephalometric Analysis: Clinical Cases

Chapter 07. 3D Analysis of the Temporomandibular Joint
• Anatomy and Pathology of the TMJ
• Radiologic Examinations of the TMJ

Chapter 08. 3D Analysis of Airway Spaces
• Obstructive Sleep Apnea
• Risk Factors for Obstruction of the Airways and Development of OSA

Chapter 09. 3D Analysis of Impacted Teeth
• Impaction of the Permanent Maxillary Canine
• 3D Imaging and Diagnosis of Impacted Mandibular Third Molars

Chapter 10. CBCT in Periodontology

Chapter 11. CBCT in Endodontics
• Imaging in Endodontics
• Cone Beam Computed Tomography in Endodontics

Chapter 12. Computer-Assisted Guided Surgery: Indications and Limitations
• Analysis of Guided-Surgery Systems

Chapter 13 CBCT: Medicolegal Issues