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Table of Contents   
LETTER TO EDITOR  
Year : 2016  |  Volume : 27  |  Issue : 4  |  Page : 450-451
Importance of cone beam computed tomography and ridge mapping gauge in determining the residual alveolar bone width for immediate implant placement


Department of Periodontics, MGV's KBH Dental College and Hospital, Nashik - 422 003, Maharashtra, India

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Date of Web Publication10-Oct-2016
 

How to cite this article:
Agrawal AA. Importance of cone beam computed tomography and ridge mapping gauge in determining the residual alveolar bone width for immediate implant placement. Indian J Dent Res 2016;27:450-1

How to cite this URL:
Agrawal AA. Importance of cone beam computed tomography and ridge mapping gauge in determining the residual alveolar bone width for immediate implant placement. Indian J Dent Res [serial online] 2016 [cited 2020 Oct 27];27:450-1. Available from: https://www.ijdr.in/text.asp?2016/27/4/450/191899
Sir,

With reference to an article published in a recent issue of your journal by Chandraker et al., [1] there are some points that need clarification and also simplification of the technique described by them.

Accurate assessment of bone dimensions around an implant could best be done by the 3D imaging using computed tomography (CT). As rightly pointed out by authors, [1] routine use of CT in dentistry is not accepted due to its cost, excessive radiation, and general practicality. However, cone beam CT (CBCT), which the authors have failed to mention in their list, is commonly used in recent years. Patient radiation dose is five times lower (29-477 μSv) than normal CT (approximately 2000 μSv), as the exposure time is approximately 18 s, i.e. one-seventh the amount compared with the conventional medical CT. [2] Furthermore, the time required for image reconstruction takes approximately 1 min for CBCT. [3]

However, if any of these diagnostic imaging facilities is not available at certain locations or the patient or doctor is not willing to get the scan done, then the technique described by the authors [1] is very useful. To make the technique less cumbersome, the last step "scraping the cast in the labial and palatal region," (as depicted in Figure 6 of the article) [1] can be eliminated. After the 7 th step, i.e. "transferring the ridge mapping reading to the sectioned cast," (as depicted in Figure 5 of the article) [1] a Vernier caliper can be used to measure the amount of bone available [Figure 1].
Figure 1: Digital mock-up of Figure 5 of the parent article[1] to demonstrate the use of Vernier caliper in determining the thickness of residual bone without trimming the cast

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Furthermore, the ridge mapping gauge (as shown in Figure 6 of the article) [1] can be used directly into the socket to determine the cortical bone thickness. Since the beaks of the gauge are already sharp, they would penetrate the soft-tissue thickness [Figure 2]. [4] One beak will stop at the outer surface of cortical plate and the other beak rests on the inner surface of the bone accessed through the socket formed immediately after extraction. In this way, we can eliminate all the impressions and plaster works and still be able to achieve our objectives.
Figure 2: Ability of the beaks of a ridge mapping gauge to penetrate the soft tissue under local anesthesia

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The technique described by the authors is economical and applicable where advanced diagnostic facilities, especially CBCT, are either not available or not affordable by the patient. However, using the ridge mapping gauge directly into the extraction socket could achieve the same objectives without the impression and plaster works.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Chandraker NK, Chowdhary R, Verma A. Technique to assess the alveolar bone width for immediate implant placement in fresh extraction sockets. Indian J Dent Res 2013;24:784-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Mohan R, Singh A, Gundappa M. Three-dimensional imaging in periodontal diagnosis - Utilization of cone beam computed tomography. J Indian Soc Periodontol 2011;15:11-7.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Orth RC, Wallace MJ, Kuo MD; Technology Assessment Committee of the Society of Interventional Radiology. C-arm cone-beam CT: General principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 2008;19:814-20.  Back to cited text no. 3
[PUBMED]    
4.
Somborac M. Implants for Single Tooth Replacement in the Esthetic Zone: Immediate Insertion Compared to Delayed Insertion Treatment in a Private Practice. Oral Health Group; August, 2008. Available from: http://www.oralhealthgroup.com/issues/toc.aspx?edition=8/1/2008. [Last cited on 2014 Mar 21].  Back to cited text no. 4
    

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Correspondence Address:
Amit Arvind Agrawal
Department of Periodontics, MGV's KBH Dental College and Hospital, Nashik - 422 003, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.191899

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