Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report.

PURPOSE: The International Congress of Oral Implantologists has supported the development of this consensus report involving the use of Cone Beam Computed Tomography (CBCT) in implant dentistry with the intent of providing scientifically based guidance to clinicians regarding its use as an adjunct to traditional imaging modalities. MATERIALS AND METHODS: The literature regarding CBCT and implant dentistry was systematically reviewed. A PubMed search that included studies published between January 1, 2000, and July 31, 2011, was conducted. Oral presentations, in conjunction with these studies, were given by Dr. Erika Benavides, Dr. Scott Ganz, Dr. James Mah, Dr. Myung-Jin Kim, and Dr. David Hatcher at a meeting of the International Congress of Oral Implantologists in Seoul, Korea, on October 6-8, 2011. RESULTS: The studies published could be divided into four main groups: diagnostics, implant planning, surgical guidance, and postimplant evaluation. CONCLUSIONS: The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.

Systematic approach for the propagation of postgraduate dental implant education in developing countries.

PURPOSE: To analyze the outcome of the formative feedback and summative assessment in 2 different groups of dentists after a postgraduate dental implant course. This course was conducted with the hope of developing a systematic approach to implant dentistry training. METHODS: A 6-day mini-residency postgraduate dental implant course which was approved for 75 credit hours by the international congress of oral implantologists and approved for fellowship after a satisfactory grade at the end of course examination was conducted at the Faculty of Dentistry of the University of Ibadan in West Africa. This course was organized by the Caribbean affiliate of the International Congress of Oral Implantologists utilizing the syllabus which has been instrumental in training Caribbean Dentist since 2004. The postgraduate course in implantology was delivered to 2 groups of participants: group I comprising mainly of faculty staff from the major dental schools in Nigeria with previous postgraduate qualifications and group II were general dental practitioners in private practice in Nigeria.The outcome of the assessment by the 2 different groups was compared with the outcome of implant postgraduate courses in dentistry that are presently documented in Medline/Pubmed. RESULTS: There was no significant difference in the reason for attending the course when the 2 groups are compared (P value ranged from 0.82 to 0.93). Both groups expressed good and similar response to the overall quality of the presentation (P value = 0.19), comprehensiveness of topics covered (P value = 0.34), organization of presentation (P value = 0.34). The multiple choice question assessment at the end of the course was very difficult for both groups and the performance was below average for both groups. CONCLUSIONS: The 6-days mini-residency course combined with the 1-month distance learning component was adequate for the sustainability stage and this lead to certification of 72% of the delegates via the examination route.

Rationale for the application of immediate load in implant dentistry: part II.

Immediate loading of an implant interface has been used for completely and partially edentulous patients. A biomechanical rationale to decrease the initial risk of overload is reasonable, because implant failure and overload has been well established. This article addresses methods to decrease stress to the transitional restoration. Forces may be influenced by patient factors, implant position, cantilever forces, occlusal load direction, occlusal contact intensity, and diet. The surface area of load distribution may be increased by implant size, implant design, and surface condition of the implant body. A blend of these factors affects the amount of stress to the developing implant interface and hence may affect the risk of immediate occlusal loading for implant prostheses.

Rationale for the application of immediate load in implant dentistry: Part I.

Immediate loading in implant dentistry is increasing in popularity as a clinical procedure. A scientific rationale of immediate occlusal loading of the implant support system should emphasize methods to decrease surgical trauma during implant placement and to decrease bone loading trauma during the early loading period. The surgical trauma may be reduced by decreasing heat generation and pressure necrosis. The early loading trauma may be decreased by decreasing the bone strain adjacent to the implant interface. Greater microstrain conditions in bone increase the remodeling rate of bone. The higher the remodeling rate, the weaker the bone and the more risk of occlusal overload. Occlusal overload may lead to implant failure. Since strain is directly related to stress, methods to decrease stress are beneficial. In the present report, the stress-reducing influences include increasing the number of implants.