Case Report Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone Corina Marilena Cristache Faculty of Midwifery and Medical Assisting, “Carol Davila” University of Medicine and Pharmacy, 8 Blvd Eroilor Sanitari, 050474 Bucharest, Romania Correspondence should be addressed to Corina Marilena Cristache; corinacristache@gmail.com Received 29 October 2016; Revised 17 January 2017; Accepted 1 February 2017; Published 22 February 2017 Academic Editor: Yuk-Kwan Chen Copyright © 2017 Corina Marilena Cristache. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Despite numerous advantages over multislice computed tomography (MSCT), including a lower radiation dose to the patient, shorter acquisition times, afordable cost, and sometimes greater detail with isotropic voxels used in reconstruction, allowing precise measurements, cone beam computed tomography (CBCT) is still controversial regarding bone quality evaluation. Tis paper presents a brief review of the literature on accuracy and reliability of bone quality assessment with CBCT and a case report with step-by-step predictable treatment planning in esthetic zone, based on CBCT scans which enabled the clinician to evaluate, depending on bone volume and quality, whether immediate restoration with CAD-CAM manufactured temporary crown and fapless surgery may be a treatment option. 1. Introduction Nowadays, cone beam computed tomography (CBCT) sys- tems replaced multislice computed tomography (MSCT) for dental treatment and planning due to many advantages ofered, including a lower radiation dose to the patient, shorter acquisition times [1, 2], afordable cost, better res- olution, and sometimes greater details [3, 4]. CBCT uses isotropic voxels and, as a result, measurements are precise and considered 1 : 1; therefore study models and 3D printing or milling surgical templates can be fabricated with great accu- racy [5]. Despite these preference factors, the reliability, consistency, and accuracy of CT numbers derived from CBCT imaging systems in bone quality evaluation remain controversial [6]. Terefore gray values resulting from the CBCT scan are referred to as voxel values (VVs) and not HU. Te imprecision of the intensity values of CBCT systems is commonly attributed to diferences in characteristics of the devices (kVp, mA, exposure time), the imaging parameters (voxel size), and the position or feld of view (FOV) of the area being evaluated [7, 8]. Several studies [6–9] performed on homogenous phan- toms and nonhomogenous materials (similar to human tissues) using diferent CBCT scanners demonstrated linear correlation between CBCT gray scale and HU. Other studies [10–13] focused on investigating the rela- tion between bone characteristics obtained from CBCT scan and primary stability of the implants found a direct correlation between VVs, insertion torque value (ITV), and implant stability quotient (ISQ). Moreover, Gonz´ alez-Garc´ ıa and Monje [14] were the frst authors to report that a strong positive correlation was present between radiological bone density (RBD) assessed by CBCT and bone density assessed by micro-CT (considered “gold-standard” for evaluating bone morphology) at the site of dental implants in the native maxillary bones. Tey also stated that preoperative estimation of density values by CBCT was a reliable tool to objectively determine bone density. Based on the previous experience by Gonz´ alez-Garc´ ıa [14], his group also supported later the use of CBCT as preoperative tool for implant treatment planning because it Hindawi Case Reports in Dentistry Volume 2017, Article ID 1096365, 8 pages https://doi.org/10.1155/2017/1096365