Planning Of Dental Implants Research Articles

The Role and Applications of Artificial Intelligence in Dental Implant Planning: A Systematic Review.

Artificial intelligence (AI) is revolutionizing dentistry, offering new opportunities to improve the precision and efficiency of implantology. This literature review aims to evaluate the current evidence on the use of AI in implant planning assessment. The analysis was conducted through PubMed and Scopus search engines, using a combination of relevant keywords, including "artificial intelligence implantology", "AI implant planning", "AI dental implant", and "implantology artificial intelligence". Selected articles were carefully reviewed to identify studies reporting data on the effectiveness of AI in implant planning. The results of the literature review indicate a growing interest in the application of AI in implant planning, with evidence suggesting an improvement in precision and predictability compared to traditional methods. The summary of the obtained findings by the included studies represents the latest AI developments in implant planning, demonstrating its application for the automated detection of bones, the maxillary sinus, neuronal structure, and teeth. However, some disadvantages were also identified, including the need for high-quality training data and the lack of standardization in protocols. In conclusion, the use of AI in implant planning presents promising prospects for improving clinical outcomes and optimizing patient management. However, further research is needed to fully understand its potential and address the challenges associated with its implementation in clinical practice.

Tomographic Planning of Dental Implants Using a Smartphone: Linear Measurements and Implant Selection-A Cross-Sectional Study.

This study assessed the accuracy of linear measurements and dental implant selection performed in a smartphone application compared to a computer software. Forty-four DICOM files from partially edentulous patients in the posterior region of the mandible were evaluated by three trained and calibrated examiners. Images were analyzed using three visualization methods: cross-sectional view (CScr) and coronal (CSco) plane using the CS 3D Imaging software, and coronal (DRco) plane using the DroidRender smartphone application. For the purpose of standardization, measurements of bone width and height were taken in the edentulous posterior region of the mandible, 10 mm posterior to the mental foramen. Dental implant selection was made according to Straumann® Standard implant catalog 2022/2023. Linear measurements were compared using the ANOVA test for repeated measurements and implant selection was compared using the Friedman test. Statistical analysis was performed using the SPSS software, considering a significance level of 5%. Linear measurements showed a statistically significant difference for bone width (p = 0.030), but not for height (p = 0.685). The choice of implant was not influenced by the visualization method (p = 0.614). It is possible to suggest the use of smartphone applications as an additional diagnostic tool for DICOM evaluation and dental implant planning in the posterior region of the mandible. Smartphone applications allow an assessment not limited to 2D images or to static environments. Therefore, information exchange and diagnostic opinion in emergency situations may be facilitated.

Impact of 3D imaging techniques and virtual patients on the accuracy of planning and surgical placement of dental implants: A systematic review.

The integration of advanced technologies, including three-dimensional (3D) imaging modalities and virtual simulations, has significantly influenced contemporary approaches to preoperative planning in implant dentistry. Through a meticulous analysis of relevant studies, this review synthesizes findings related to accuracy outcomes in implant placement facilitated by 3D imaging in virtual patients. A comprehensive literature search was conducted across relevant databases to identify relevant studies published to date. The inclusion criteria were studies utilizing 3D imaging techniques, virtual patients, and those focusing on the accuracy of dental implant planning and surgical placement. The selected studies were critically appraised for their methodological quality. After a rigorous analysis, 21 relevant articles were included out of 3021 articles. This study demonstrates the versatility and applicability of these technologies in both in vitro and in vivo settings. Integrating Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), cone bean computed tomography (CBCT), and advanced 3D reconstruction methodologies showcases a trend toward enhanced precision in implant planning and placement. Notably, the evaluation parameters varied, encompassing distances, discrepancies, and deviations in the implant placement. The ongoing integration of systems such as dynamic navigation systems, augmented reality, and sophisticated software platforms shows a promising trajectory for the continued refinement of virtual reality applications in dental implantology, providing valuable insights for future research and clinical implementation. Moreover, using stereolithographic surgical guides, virtual planning with CBCT data, and 3D-printed templates consistently demonstrates enhanced precision in dental implant placement compared to traditional methods. The synthesis of the available evidence underscores the substantial positive impact of 3D imaging techniques and virtual patients on dental implant planning and surgical placement accuracy. Utilizing these technologies contributes to a more personalized and precise approach that enhances overall treatment outcomes. Future research directions and potential refinements to the application of these technologies in clinical practice should be discussed.

Comparative Assessment of Three Different Alveolar Ridge Dimension Measurement Methods before Implant Placement: An In Vivo Study.

The purpose of this study was to compare the three various techniques for measuring the alveolar ridge's dimensions prior to implant insertion. For this study, a total of 36 participants were chosen. To prepare a surgical stent, a study model was created from an alginate impression. A first point (reference point) was marked on the crest of the ridge in relation to the adjacent teeth. Then, one point (point 1) and another point (point 2) were marked at distances of 3 and 6 mm, respectively, from the reference point. Based on the procedure for measuring the size of the alveolar ridge, the study was divided into the following groups. Group I: Cone-beam computed tomography (CBCT) measurement method; Group II: Ridge mapping measurement method; Group III: Direct caliper measurements method. Descriptive statistics were used to estimate the mean and standard deviation (SD). The Student's unpaired t-test was utilized for the statistical analysis. The 5% level of significance was used. There was no significant difference found between CBCT with ridge mapping and direct caliper measurements. However, on comparison of ridge mapping and direct caliper measurements technique, at point 1, the ridge mapping was 3.88 ± 0.12 and the direct caliper measurement was 3.62 ± 0.08. At point 2, the ridge mapping was 6.58 ± 0.06 and the direct caliper measurement was 6.32 ± 0.04. There was a statistically significant difference found between these two measurement methods. Within the limitation, the current study came to the conclusion that when CBCT and ridge mapping measurements were individually compared with the gold standard-the surgical open method, CBCT-demonstrated to be a highly specific and sensitive method for detecting the residual alveolar ridge width in the treatment planning of dental implants. Evaluation of alveolar bone is necessary during treatment planning for dental implant placement. Using simply panoramic and/or periapical radiographs to evaluate the bone may not be sufficient because it only provides two-dimensional information regarding the implant locations. Therefore, for better implant placement, three-dimensional information of the implant site, such as CBCT and ridge mapping technique, should be assessed.

Comparative Assessment of Crestal Bone Loss by Flapless and Flap Technique for Implant Placement: A Prospective Study.

The use of flapless surgery for placing dental implants is extremely popular due to better radiological tools and the availability of software that help in the planning of dental implants. The present study was done to assess crestal bone loss by using flapless and flap techniques for placing implants. A total of 50 subjects who satisfied the inclusion criteria were selected for this study.Selected patients were then divided equally into two study groups i.e., those who are and those who are notundergoing flap surgery. Statistical analysis was done using the Mann-Whitney U test. Statistically considerable P values were obtained. Bone loss was lesser with the flapless technique. Flapless implant placement demonstrated less crestal bone loss compared to flap surgery.

Artificial intelligence and augmented reality for guided implant surgery planning: A proof of concept

PurposeTo present a novel protocol for authentic three-dimensional (3D) planning of dental implants, using artificial intelligence (AI) and augmented reality (AR). MethodsThe novel protocol consists of (1) 3D data acquisition, with an intraoral scanner (IOS) and cone-beam computed tomography (CBCT); (2) application of AI for CBCT segmentation to obtain standard tessellation language (STL) models and automatic alignment with IOS models; (3) loading of selected STL models within the AR system and surgical planning with holograms; (4) surgical guide design with open-source computer-assisted-design (CAD) software; and (5) surgery on the patient. ResultsThis novel protocol is effective and time-efficient when used for planning simple cases of static guided implant surgery in the partially edentulous patient. The clinician can plan the implants in an authentic 3D environment, without using any radiological guided surgery software. The precision of implant placement looks clinically acceptable, with minor deviations. ConclusionsAI and AR technologies can be successfully used in guided implant surgery for authentic 3D planning that may replace conventional software. However, further clinical studies are needed to validate this protocol. Statement of clinical relevanceThe combined use of AI and AR may change the perspectives of modern guided implant surgery for authentic 3D planning that may replace conventional software.

Reliability of Using Texture Analysis of Periapical Radiographs Obtained Using Radiovisiography for Assessing Bone Quality in Dental Implant Planning: A Cross-Sectional Study.

Background Pre-prosthetic implant radiographic imaging helps in the quantitative and qualitative analysis of the bone structure and also enables the evaluation of the relationship between critical structures and potential implant sites. Purpose The aim of the study was to define the reliability of utilizing the analysis of textures from the periapical radiographic imagesobtained through Radiovisiography (RVG) in order to better plan for dental implantations. Methods A cross-sectional study was conducted using 50 intraoral periapical radiographs which were obtained through RVGperformed prior to the placement of implants. The radiographs were segregated based on anatomical locations i.e. 12 for the anterior maxilla, nine for the posterior maxilla, seven for the anterior mandible, and 22 for the posterior mandible. Each of the radiographs was visually assessed by four experienced examiners, namely a Prosthodontist E1, Periodontist E2, Oral surgeon E3, and Oral radiologist E4, which was then compared to an experienced operator's tactile perception during a pilot drill for implant placement. As a reference, the Lekholm and Zarb classification was provided to all the examiners for them to qualitatively assess the bone structure in the radiographs. Results The examiners' results were correlated with the assessment provided by the experienced operator. E1 and E4 successfully assessed 42% of the radiographs while E2 had the least success with only 26%. Of the 12 anterior maxillary radiographs, only eight were accurately assessed by E1. With respect to the posterior maxilla, all examiners correctly assessed four radiographs each. Of the seven anterior mandibular radiographs, except for E2, the rest correctly assessed three radiographs each. Of the 22 posterior mandibular radiographs, only nine were accurately assessed by E4. Conclusion Intraoral periapical radiographsobtained through RVG did not meet the desired parameters for assessing the bone quality during the planning stage for implants.

Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone-beam computed tomography and 3D double-echo steady-state MRI.

To evaluate image quality and diagnostic accuracy of buccal bone thickness assessment in maxillary and mandibular anterior region using cone-beam computed tomography (CBCT) and 3-dimensional double-echo steady-state (DESS) MRI for preoperative planning of immediate dental implants in healthy individuals. One hundred and twenty teeth in 10 volunteers were retrospectively evaluated for image quality and artifacts using Likert scale (4=excellent to 0=decreased). Buccal bone thickness was measured at three measurement points (M1=2 mm from the cementoenamel junction, M2=middle of the root, and M3=at the root apex) for each tooth in the maxillary (13-23) and the mandibular anterior region (33-43). Descriptive statistics and two-way ANOVA with Tukey's Post-hoc test were performed to evaluate the significant differences (α=0.05) between both imaging modalities. Image quality showed little to no artifacts and enabled confident diagnostic interpretation (CBCT (3.72 ± 0.46); MRI (3.65 ± 0.49)), with no significant differences between both imaging modalities (p > 0.05). Regarding the assessment of buccal bone thickness at M1-M3 for the teeth 13-23 and 33-43, no significant differences were noted (p > 0.05). MRI demonstrated slight, nonsignificant overestimation of thickness with the canines having mainly a thick buccal bone wall, where thin buccal wall was evident for the central incisors. Black bone MRI sequences, such as 3D-DESS MRI, for immediate implant planning provided confidential diagnostic accuracy in bone thickness assessment without significant disadvantages compared to CBCT. Thus, the implementation of no-dose protocols for dental rehabilitation using an immediate loading approach seems promising and could further improve the treatment strategy for dental rehabilitation.

Knowledge and Level of Awareness About Dental Implants Amongst the Dental Undergraduate Students and Interns

Dental implants are becoming the focus of interest for the replacement of missing teeth among dental practitioners. For the planning of dental implants, it is important to have proper knowledge and awareness about implants as it directly or indirectly affects the treatment outcome and patient satisfaction. This study was conducted to assess the level of knowledge and awareness about dental implants amongst dental undergraduate students and interns. A web-based questionnaire survey consisting of 14 questions on dental implants was conducted among 200 participants. The participants were undergraduate dental students and interns from all over India and it was assessed by the investigator using percentage. In this study, it was found that the undergraduate students and interns are very much aware of dental implants (approx. 92%) and also the various questions regarding dental practices were answered positively. This survey had concluded that there is an acceptable level of knowledge and awareness regarding the use of dental implants as a treatment option for replacing missing teeth.

Mesiodistal Measurements for Dental Implant Planning: A Prospective Clinical Study of Linear Measurements on Cone-Beam Computed Tomography Images in Comparison with Caliper-Based Measurements on Plaster Casts.

Althouh cone beam computed tomography (CBCT) is popular for dental implant planning, the horizontal mesiodistal space of the edentulous ridge is still conventionally measured with a handheld sliding caliper in the oral cavity or on a plaster cast. For clinical application in implant planning, our aim was to evaluate the accuracy of CBCT horizontal mesiodistal linear measurements in comparison with conventionally obtained direct measurements on plaster casts. Postoperative CBCT acquisitions and plaster casts of 27 patients with adjacent posterior mandibular implants were analyzed in a prospective clinical study. On CBCT images, two observers assessed the inter-implant distances on axial and sagittal views. On plaster casts, the inter-implant distances were measured with a digital caliper. CBCT measurements on axial and sagittal views were, on average, 0.2 mm larger than measurements on plaster casts. Correlation was perfect between measurements of the same inter-implant distance performed by the observers on CBCT images and on plaster casts. When compared with conventionally obtained direct measurements on plaster casts, CBCT views slightly overestimated (mean 0.2 mm) the horizontal mesiodistal measurements between two implants as reference points. CBCT imaging is sufficiently accurate to evaluate mesiodistal distances on axial and sagittal views for dental implant planning in clinical practice.

Deep Learning Based Detection of Missing Tooth Regions for Dental Implant Planning in Panoramic Radiographic Images

Dental implantation is a surgical procedure in oral and maxillofacial surgery. Detecting missing tooth regions is essential for planning dental implant placement. This study proposes an automated method that detects regions of missing teeth in panoramic radiographic images. Tooth instance segmentation is required to accurately detect a missing tooth region in panoramic radiographic images containing obstacles, such as dental appliances or restoration. Therefore, we constructed a dataset that contains 455 panoramic radiographic images and annotations for tooth instance segmentation and missing tooth region detection. First, the segmentation model segments teeth into the panoramic radiographic image and generates teeth masks. Second, a detection model uses the teeth masks as input to predict regions of missing teeth. Finally, the detection model identifies the position and number of missing teeth in the panoramic radiographic image. We achieved 92.14% mean Average Precision (mAP) for tooth instance segmentation and 59.09% mAP for missing tooth regions detection. As a result, this method assists diagnosis by clinicians to detect missing teeth regions for implant placement.

Preservation of Alveolar Ridge using Graft Material after Tooth Extraction: A Clinical Trial.

Background:The alveolar process is a tooth-dependent structure, and hence, removal of teeth results in the alteration of alveolar process. To alter bone remodeling after dental extraction, various techniques have been put forward for ridge preservation.Aim:The aim of this study is to evaluate and compare the changes of hard and soft tissues in postextraction socket after the application of bone graft material.Materials and Methods:Healthy patients of sample size of 40 were selected who underwent the extraction of anterior tooth irrespective of the arch, from premolar of one side to another, with the exception of incisors in mandible. Twenty patients were randomly selected as the control group and other 20 as the experimental group using an allograft bone material, i.e., beta-tricalcium phosphate to fill the socket. Cone-beam computed tomography (CBCT) was done as baseline preoperative and postoperative at 14 weeks after the extraction. CBCTs data help in recording linear and volumetric measurements which was performed by calibrated examiners to record all the measurements. After measurements, digital planning of dental implants was performed.Results:Forty participants were selected, in which 20 patients each were as the experimental and control groups. No significant difference was found at basal line at any of the cases. At follow-up of 14 weeks, statistical significance was seen in buccal and lingual plate height in the experimental group, and no significant difference was seen in the control group.(P = 0.023).Conclusions:This study clearly points out that an alveolar ridge preservation technique provides therapeutic benefit by limiting bone resorption in comparison to extraction alone.

Influence of Low-Dose Protocols of CBCT on Dental Implant Planning.

To evaluate the influence of low-dose protocols, with different numbers of basis images, on the precision of linear bone measurements in CBCT images. Five polyurethane mandibles, with different levels of bone resorption, were used in this in vitro study. To obtain the reference standard, landmarks were made in the mandibular superior and buccal cortices, and then a digital caliper was used to measure the bone height and thickness at these regions. CBCT images were obtained with the PaX-i3D (Vatech) unit set at 50 kV, 4 mA, 0.2-mm voxel size and 50 × 50-mm field of view. Keeping these parameters fixed, each mandible was scanned twice, with different protocols: Low dose (L) had an acquisition time of 24 seconds and 720 basis images, and ultralow dose (UL) had an acquisition time of 15 seconds and 450 basis images. Then, measurements of bone height and thickness were performed on the images, using the previously determined landmarks as reference. The obtained data were submitted to statistical analysis, with a significance level of .05. Analysis of variance, Student t test, and intraclass correlation coefficient were employed. Regarding bone height, there were no significant differences between the measurements obtained with the L and UL protocols (P = .8648). Additionally, the L and UL protocols did not differ in relation to the reference standard (P = .8717 and P = .9928, respectively). Likewise, there were no significant differences between the measurements obtained with the L and UL protocols (P = .7969) for bone thickness, nor between these protocols and the gold standard (P = .7455). Considering the great demand for precise measurements in implantology, protocols of low-dose radiation can be used without compromising clinical planning.

Assessment of Trabecular Bone During Dental Implant Planning using Cone-beam Computed Tomography with High-resolution Parameters

Background: Cone-Beam Computed Tomography (CBCT) with high-resolution parameters may provide an acceptable resolution for bone assessment. Objectives: The purpose of this study is to assess trabecular bone using two cone-beam computed tomography (CBCT) devices with high-resolution parameters in comparison to micro-computed tomography (µCT). Methods: Bone samples (n=8) were acquired from dry mandibles and scanned by two CBCT devices: 1) VV (Veraview R100, Morita; FOV 4x4, 75kV, 9mA, voxel size 0.125µm); and PR (Prexion 3D, Prexion; FOV 5x5, 90kV, 4mA, 37s, voxel size 108µm). Gold-standard images were acquired using µCT (SkyScan 1272; Bruker; 80kV, 125mA, voxel size 16µm). Morphometric parameters (BvTv- Bone Volume Fraction, BsBv- Trabecular specific surface, TbTh- Trabecular thickness and TbSp- Trabecular separation) were measured. Statistical analysis was performed within ANOVA, Spearman Correlation test and Bland-Altmann plots with a statistical significance level at p=0.05. Results: CBCT devices showed similar BvTv values in comparison to µCT. No statistical difference was found for BvTv parameters assessed by CBCT devices and µCT. BsBv values were underestimated by CBCT devices (p<0.01), whereas TbTh and TbSp values were overestimated by them (p<0.01). Positive correlations were found between VV and µCT measurements for BvTv (r2= 0.65, p=0.00), such as between PR and µCT measurements for TbSp (r2= 0.50, p=0.04). For BsBv measurements, PR was negatively correlated with µCT (r2= -0.643, p=0.01). Conclusion: The evaluated CBCT device was able to assess trabecular bone. However, bone parameters were under or overestimated in comparison to µCT.

Automated CNN-Based Tooth Segmentation in Cone-Beam CT for Dental Implant Planning

Accurate tooth segmentation is an essential step for reconstructing the three-dimensional tooth models used in various clinical applications. In this paper, we propose a convolutional neural network (CNN) based method for fully-automatic tooth segmentation with multi-phase training and preprocessing. For multi-phase training, we defined and used sub-volumes of different sizes to produce stable and fast convergence. To deal with the cone-beam computed tomography (CBCT) images from various CBCT scanners, we used a histogram-based method as a preprocessing step to estimate the average gray density level of the bone and tooth regions. Also, we developed a posterior probability function. Regularizing the CNN models with spatial dropout layers and replacing the convolutional layers with dense convolution blocks further improved the segmentation performance. Experimental results showed that the proposed method compared favorably with existing methods.

RELATION OF CONE BEAM COMPUTED TOMOGRAPHY ASSESSMENT OF MANDIBULAR BONE DENSITY TO DUAL ENERGY X-RAY ABSORPTIOMETRY IN TYPE 2 DIABETES MELLITUS PATIENTS

INTRODUCTION: One of the complications associated with diabetes mellitus is decrease in bone mineral density (BMD). Therefore, quantification of BMD for these patients before a dental implant procedure is essential. Cone beam computed tomography (CBCT) is an important tool that can be used for qualitative and quantitative bone assessment for treatment planning of dental implants. OBJECTIVES: Evaluation of mandibular bone mineral density measured by CBCT and its correlation to T-score obtained by dual energy xray absorptiometry (DEXA) in relation to blood glycemic control as detected by glycosylated hemoglobin (HbA1c) in type 2 diabetic patients (T2DM). MATERIALS AND METHODS: The study was conducted clinically on twenty-four patients having T2DM, referred for CBCT examination as a part of implant planning. BMD was measured for each edentulous mandibular space using CBCT scan. The patients were grouped according to the level of HbA1c into 4 groups; control group, well-controlled group, moderately controlled group and poorly controlled group. Additionally, each candidate was examined radio-graphically using DEXA. Then, a statistical correlation between HbA1c values in relation to mandibular BMD values and T-score values was investigated. RESULTS: there was a statistically significant correlation between HbA1c values and BMD variables including: mandibular edentulous quad BMD and T-score values (p <0.001), and a statistically significant correlation between T-score value and Mandibular edentulous quad BMD (p <0.001). CONCLUSIONS: Osteoporosis is a commonly underestimated problem in diabetes patients. Osteoporosis can be predicted using CBCT, so it’s the dentist responsibility to refer osteoporotic patients once being suspected.

Treatment Planning of Dental Implants in the Anterior Maxilla; Risk Assessment and Review of Soft Tissue along with Bone Preservation and Augmentation Techniques for Successful Clinical Outcomes

The anterior maxilla continues to present with high potential risk for esthetic failure, and as a result, there is a clear need for modifications that would allow for natural-looking restorations that are harmonious with the rest of the mouth. A number of changes in protocol for placing implants such as using a restorative-driven protocol, the performance of a risk assessment and addressing factors that could compromise esthetics such as deficiencies in bone and soft tissue using bone and soft tissue grafts to ensure adequate tissue volume are necessary for dental implant overall success in the anterior maxilla. Understanding of timing with regard to implant placement has also contributed to achieving esthetic success in the region. This article reviews modifications made in implant placement in the esthetic zone and how they can contribute to functional and esthetic success in the anterior maxilla.

Outcome of Autotransplantation of Mature Third Molars Using 3-dimensional–printed Guiding Templates and Donor Tooth Replicas

Autotransplantation exhibits a number of advantages compared with other treatment options (ie, dental implants or fixed partial prostheses), such as greater resistance to occlusal loading, maintenance of the periodontal ligament and surrounding bone, and the potential for better esthetics. The aim of this study was to determine clinical outcomes for autotransplanted teeth with complete root formation using 3-dimensional–printed guiding templates and tooth replicas. Twenty-seven third molars with completely formed roots were autotransplanted. Each donor tooth and recipient site were examined clinically and radiographically (periapical radiographs). A selective cone-beam computed tomographic scan was taken of each donor tooth and recipient site. The images of the selected donor teeth were segmented and saved as stereolithography files. Similar to virtual planning of dental implants, correct angulation, rotation, and accurate positioning of the donor teeth were predefined using the stereolithography files. According to the virtually defined positions and dimensions of the donor teeth, 3-dimensional guiding templates and donor tooth replicas were printed. All autotransplantations were performed according to 1 treatment protocol and surgical technique. In 22 of the 24 transplanted teeth, no inflammation occurred during the healing period. At 2 years, no pathologic radiolucency or tooth resorption was observed in the 22 donor teeth. The autotransplanted teeth fulfilled the success criteria in 22 cases for a 91.7% success rate. Digital planning could potentially provide an accurate alternative to current autotransplantation techniques.

What Surprises Lie Beneath a Panoramic Radiograph in Dental Implant Planning

What Surprises Lie Beneath a Panoramic Radiograph in Dental Implant Planning

Comparison of Virtual Dental Implant Planning Using the Full Cross-Sectional and Transaxial Capabilities of Cone Beam Computed Tomography vs Reformatted Panoramic Imaging and 3D Modeling.

To compare the choice and placement of virtual dental implants in the posterior edentulous bounded regions using the full cross-sectional and transaxial capabilities of cone beam computed tomography (CBCT) vs reformatted panoramic images and three-dimensional (3D) virtual models. Fifty-two cases with posterior bounded edentulous regions (61 dental implant sites) were identified from a retrospective audit of 4,014 radiographic volumes. Two image sets were created from selected CBCT data: (1) a combination of reformatted panoramic imaging and a 3D model (PIref/3D), and (2) the full 3D power in CBCT image volume analyses (XS). One virtual implant was placed by consensus of three prosthodontists in each image set: PIref/3D and XS. The choice of implant length and the perceived need for ridge augmentation were recorded for implant placement in both test situations. All the virtual implant placements from both PIref/3D and XS image sets were inspected retrospectively using virtual 3D models, and the number of exposed threads on both the buccal and lingual/palatal aspects of the virtual dental implant was evaluated. The chi-square and paired t tests were used with the level of significance set at α = .05. Shorter implants were chosen more often using XS than PIref/3D (P = .001). Fewer threads were exposed when placed with XS than with PIref/3D (P = .001). The use of XS reduced the perceived need for ridge augmentation compared with PIref/3D (P = .001). The use of the full 3D power of CBCT (including cross-sectional images in all three orthagonal planes and transaxially) provides supplemental information that significantly changes the choice of virtual implant length and vertical position of the implant, and reduces the frequency of perceived need for ridge augmentation before implant placement.