Is Cone Beam Computed Tomography Always Necessary for Dental Implant Placement?

Publication date: Available online 15 November 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): George Deeb, Ludmils Antonos, Samuel Tack, Caroline Carrico, Daniel Laskin, Janina Golob Deeb
PurposeThe use of cone beam computed tomography (CBCT) for evaluation of patients for dental implants has gained considerable popularity. This retrospective cohort study was designed to determine if using a clinical examination and a panoramic radiograph (Panorex) for implant selection and determining the need for bone grafting would be comparable to using a CBCT in routine implant cases.Patients and MethodsThe implant size and need for bone grafting was initially determined in 82 patients using a panoramic radiograph and clinical examination. These patients subsequently underwent a CBCT and were again treatment planned by the same surgeon using Simplant treatment planning software in addition to a clinical examination. The length and width of implants selected by each method and the need for bone grafting were recorded and the results were compared statistically with each other and with the actual treatment subsequently rendered.ResultsBoth the Panorex method and the CBCT method accurately predicted implant width to within 1.5mm of the implant actually placed in 100% of cases and length to within 1.5mm in greater than 95% of cases. For bone graft prediction the results indicated that neither the Panorex method nor CBCT method differed significantly from the actual treatment rendered.ConclusionsThe results of this study indicate that the CBCT is more accurate in predicting implant length and width as well as the need for bone grafting procedures. However, for routine unguided implant placement in sites where anatomic structures and bone grafting are not a concern, the use of a panoramic radiograph may be adequate for determining the length and width of the implant.



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