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Use of prosthesis-generated computed tomographic information for diagnostic and surgical treatment planning.

Diagnosis, treatment planning, and prediction of a final implant-supported prosthetic outcome require precise noninvasive presurgical information. By combining the use of a clinically verified barium-coated template and interactive computed tomography (SIM/Plant, Columbia Scientific, Inc., Columbia, Maryland), the implant team can determine and address the relevant issues affecting treatment outcomes. Those issues include: implant-prosthesis incompatibility, recognition of anatomic limitations and anomalies, the need for presurgical bone augmentation, implant diameter and distribution, abutment type and angle, bone density, soft tissue augmentation requirements, accurate fee determination, and medicolegal protection. The data collection methodology and format for the Mecall and Rosenfeld prosthesis prediction analysis are discussed as part of case presentation.