Enhancing Implant Surgery Planning via Computerized Image Processing

Abstract: Computerized tomography (CT) and magnetic resolution imaging (MRI) are the medical imaging modalities to deliver cross-sectional images of the human body. In the last decade, CT has become the most frequently used imaging modality for the evaluation of the jaw for dental implants (see [Rot98]). Furthermore, image reformatting software has been developed in order to obtain a correct pre-operative diagnosis and treatment planning regarding osseointegrated implants (see, for instance, [CSIa] and [CSIb]). Previous work (see [Cla90]) has shown that CT images are affected by a distortion ratio from 0 to 6 percent. This might be due to the alignment of the patient during the scanning, to his/her movements and eventually to the saturation of pixels composing the image. To solve the first cause, intraoral stents can be used for centering the patient’s head perpendicularly to the axis of the implant to be installed. However, when more than one implant have to be installed, eventually with very different axes, it is better to not expose the patient to multiple CT scanning, which would be necessary to have different CT acquisitions each one perpendicular to the axis of one of the planned teeth.In this work, we present a software approach for enhancing implant surgical planning in order to get exact morphological measurements of the bone and planned teeth by a single CT acquisition. This is achieved by applying image-processing techniques to the original CT images, in order to produce new CT images lying on different planes, and eventually perpendicular to a different tooth. The resulting software system (named DentalVox) has been implemented in C++ and runs on Intel-based personal computers under the Windows operating system. DentalVox ensures better mechanical results in the design and planning of a dental implant with respect to other similar software tools, being able to reconstruct axial (and panorex and cross-sectional) images once any direction is chosen. This allows to get a better mechanical and aestethic prothesis implantata in the underlying jaw bone morphology.

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