Volumetric analysis of mandible for dental implants in cbct images

Author: 
Venkata Krishnan, C. J., Bhuminathan, S. and Chitraa R. Chandran

Aim: Osteoporotic patients require particular attention during implant placement, and bone density has been established as a simple method to assess local bone quality and primary implant stability. This study aimed to examine and significantly correlate the relationship of local bone density volumetric analysis as assessed by the CBCT in a group of osteopenic and osteoporotic patients. Materials and Methods:A total of 30 patients were included in the study. The mandibular Second premolar region was choosen as the site of investigation to prevent Variability in surgical implant placement technique in different locations affecting bone mineral density. Partially edentulous female patients between 51 years and 60 years of age who were scheduled to receive implant placement were recruited for the study. Ultrasound bone densitometer was used in the study to divide the three groups (Group I-Normal patients), (Group II-Osteopenic patients), (Group III-Osteoporotic patients). CBCT (Master Series 3D Dental Imaging) was used for preoperative evaluation of the jaws for each patient.Materialise's Interactive Medical Image Control System (MIMICS) was used to process stacks of 2D images from CBCT. 3-matic software was used to combine CAD tools with pre-processing (meshing) capabilities like the anatomical data coming from the segmentation of medical images (from Mimics). All data were collected and analyzed using SPSS 16.0 for windows version. Student T Test and One way ANOVA were calculated between groups to determine the difference in bone mineral densities. Results: A total of 30 females participated in the the study. The mean bone density for group I, group II, group III was 60364.36 mm3, 51789.65 mm3, 40468.62 mm3 respectively (Table 1,2,3). The difference in mean bone density in all three groups were statistically significant (p<0.05). (Table 4). Conclusions: The results of this study suggest that bone density values (as measured in mm3) obtained from preoperative cone beam computed tomography (CBCT) examination may be an objective technique for preoperative evaluation of bone density. This tool when combined with MIMICS software can serve as diagnostic tool for predicting implant success, thus providing the implant surgeon with an objective assessment of bone density, especially were poor bone quality is suspected.

Paper No: 
091