title: Clinical application of spiral tomography in anterior implant placement: case report.
abstract: BACKGROUND
  Placement of endosseous dental implants in edentulous areas of the anterior maxilla poses a unique challenge due to variations in the amount of residual alveolar bone. Implant position becomes crucial in cases demanding high esthetic results but possessing minimal ridge width or in cases requiring augmentation. Recent advances in spiral tomography have allowed for more precise planning and placement of endosseous implants in these challenging areas.
  
  
  METHODS
  The purpose of this report is to describe a series of clinical cases in which spiral tomography was utilized in the planning and placement of endosseous dental implants. Two cases will be described utilizing initial spiral tomographic radiographs for implant planning and surgical guide fabrication, followed by post-insertion tomography to evaluate the results of implant position and inclination.
  
  
  RESULTS
  Preimplant spiral tomograms revealed that the initial prosthetic trajectory through the proposed incisal edge of each tooth replacement would result in a final osteotomy site that would compromise the overall thickness of the facial cortical plate. After adjusting for magnification and distortion factors, new prosthetic/surgical trajectories were fabricated into the surgical guide, and this information was utilized to prepare the final implant osteotomy site. This adjustment resulted in 2 mm of residual crestal facial bone postimplant insertion, which became wider at more apical measurements. These findings were verified in the postimplant serial tomograms.
  
  
  CONCLUSIONS
  Spiral tomography was a valuable adjunct in the treatment planning phases of endosseous dental implant placement especially in cases with minimal crestal width, high esthetic demands, or where exact implant placement is critical for successful treatment outcomes.
authors.affiliation: University of Washington School of Dentistry, Seattle 98195, USA. ddixon@u.washington.edu
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Dixon
authors.forename: Rudolf
authors.initials: R
authors.lastname: Morgan
authors.forename: Lars G
authors.initials: LG
authors.lastname: Hollender
authors.forename: Frank A
authors.initials: FA
authors.lastname: Roberts
authors.forename: Robert B
authors.initials: RB
authors.lastname: O'Neal
mesh_terms: D000328:Adult; D003481:Cuspid; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D005260:Female; D006801:Humans; D007180:Incisor; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008437:Maxilla; D010347:Patient Care Planning; D011858:Radiographic Magnification; D025321:Surgery, Computer-Assisted; D036542:Tomography, Spiral Computed