CT scan and dental X-ray
When planning for dental implants, imaging methods like dental X-rays, CT scan or others can be of great help. Imaging methods will give precise information that the practitioner can use to devise an accurate treatment plan.
The dental X-rays are still the standard way to get an image of the mouth structures prior to placing the dental implants. Various views are available :
The periapical view allows the dentist to see both the tooth and the surrounding bone. One or two teeth may be visualized on a single view. It helps diagnose various periapical infections or some bone diseases.
The view is also important in assessing the level of osseointegration or bone loss around a dental implant.
Periapical radiographs are often used to determine the need for endodontic therapy as well as to visualize the successful progression of endodontic therapy once it is initiated.
Panoramic films are most often used by dentists when planning for dental implants. Panoramic films are extra-oral films that show all of the teeth as well as the maxilar and mandibular bones.
Panoramic films are very good in giving the practitioner an overall view of the clinical situation, revealing evidence of bone disease, fractures or other abnormal changes.
A skull x-ray is a picture of the bones surrounding the brain, including the facial bones, the nose, and the sinuses. Various abnormal conditions may be diagnosed: fractures, tumors, erosions or decalcifications of the bone etc.
The sinus view can reveal the position and look of the maxillary sinuses. Because implants are not allowed to penetrate the sinuses, this view might be of great help.
Because a computed tomography (CT) scan shows a much clearer picture of the sinuses and other structures, the use of standard sinus X-rays has declined.
What can the X-ray show ?
Dental X-rays are essentially like a blueprint for the practitioner, showing him whether additional procedures are required to make the implants viable, how large the implants need to be or where can the implants be placed.
Many important details are available on X-rays :
- The quality and quantity (height and width) of available bone
- The position and size of important anatomic structures that have to be avoided by dental implants: maxillary sinus, alveolar nerve in the mandible.
- Possible infections of the adjacent teeth or the alveolar bone
- The exact position of the remaining natural teeth
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body.
A CT scan provides three-dimensional images of a high quality and extreme complexity. CT scanning software is becoming a viable tool in the diagnosing of dental implant position and placement.
The CT scanning software allows the dentist to determine if bone quantity and quality exists and can be used to virtually place dental implants using the computer program prior to any surgical intervention. Thus, it eliminates the possible manual placement errors and matches planning to prosthetic requirements.
Besides that, other information is still available on a CT scan: bone infections, possible tumors, blood vessels and the position of important anatomical structures ; the use of CT scanning in complex cases helps the surgeon identify and avoid vital structures such as the inferior alveolar nerve and the sinus.
Cone beam computed tomography (CBCT)
A CBCT is a compact, faster and safer version of the regular CT. Through the use of a cone shaped X-Ray beam, the size of the scanner, radiation dosage and time needed for scanning are all dramatically reduced.
CBCT with more windows
The CBCT produces 3D types images that let the dentist look at mouth structures from different vantage points ; it can show the width of mouth structures in addition to their height. It also can show things like cysts and impacted teeth, as well as nerves and arteries that might make the implantation more challenging.
Other imaging methods are available like an ultrasound or magnetic resonance imaging (MRI) scan. These do not use radiation.
Last review and update: February 2019