Direct answer

Implant planning combines clinical examination with appropriate imaging and a plan for the final restoration. CBCT can show cross-sectional bone and nearby structures; digital or conventional impressions show teeth and soft-tissue form; planning software can merge these records to position a virtual implant beneath the intended crown. A surgical guide may help transfer that plan, but accuracy is not absolute.

Key takeaways

  • The smallest appropriate imaging field and justified exposure should be used.
  • CBCT helps assess three-dimensional anatomy; it does not diagnose every condition automatically.
  • The desired crown or bridge should be planned before implant position.
  • Guided surgery reduces some transfer variables but still requires clinical judgment.
  • Data quality, software alignment, guide fit, and surgical access affect accuracy.

What records may be used?

Records can include photographs, intraoral and panoramic radiographs, CBCT, digital or conventional impressions, bite records, facial scans, and a diagnostic tooth design. The required combination depends on the case and should be clinically justified.

What CBCT contributes

Cross-sectional imaging helps assess ridge dimensions, facial bone, sinus and nasal anatomy, nerve position, tooth roots, pathology, and possible implant trajectories. The AAOMR recommends cross-sectional assessment for implant sites and identifies CBCT as the method of choice for that information.

Restoration-first virtual planning

A proposed crown or prosthesis can be aligned with three-dimensional anatomy. The team then evaluates whether implant position and dimensions can support that restoration while respecting bone, tissue, and safety boundaries. If not, the restoration, grafting, timing, or treatment option may need to change.

Limits of guides and software

Image artifacts, segmentation, record alignment, manufacturing tolerances, guide support and fit, drill movement, mouth opening, and operator technique can produce deviations. The clinician must verify fit, anatomy, depth, and stability and be prepared to modify the plan safely.

Selected references

  1. Tyndall DA, Price JB, Tetradis S, et al. Position statement of the AAOMR on selection criteria for radiology in dental implantology with emphasis on CBCT. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:817–826.
  2. International Team for Implantology. Selection criteria for immediate implant placement and loading in the maxillary esthetic zone. ITI Consensus Conference, 2023.