Digital Comparative Method for Analysis of Body Remodeling and Neoformation: Case Report

Replace lost teeth in the anterior area of the maxilla is complex and challenging, therefore in these cases, it's essential that reverse planning lead the case. For implants can be correctly positioned, the surgeon should use grafts and bone substitutes to stabilize, maintain, and restore bone architecture. The cone-beam computed tomography (CBCT) allows a high-quality, three-dimensional view of craniofacial bone structures, and is widely used for assessing bone availability and planning for implant surgery. CBCT is also used to evaluate surgical results as it allows the visualization of the grafted area without the interposition of structures and the study of multiple areas in a single exam. The superimposed technique is one of the methods used to evaluate surgical results, consisting of superimposed the images obtained through CBCT and the intra-oral scanning, allowing a precise quantitative and qualitative analysis of tissues. The present case shows the importance of using CBCT to confirm the diagnostic hypothesis. The patient had a fracture in the abutments of the fixed partial denture (FPD) in the 11 to 21 area. Thus, the planned treatment was the extraction of the 11 and 22 roots and bone regeneration of area 22 for later installation of dental implants. The graft was performed using the modified socket seal proposed by Misch. After six months of regeneration, a new CBCT was performed and the results were measured by the superimposing technique. In a second surgery, four dental implants were installed, in a position determined by reverse planning. After four months, the temporary crowns were installed for gingival conditioning. The case was concluded with ceramic crowns, offering functionality and aesthetics to the patient. The main objective is to describe a technique of comparative digital analysis between dimensional changes of the different phases of bone structures and soft tissue.