[Oradlist] Guidelines for CT/CBCT

[Allan G Farman]

Dear Dr. Ganz: A number of CBCT related position papers are in process by the American Academy of Oral and Maxillofacial Radiology.... as applicable in conjunction with other groups in the USA (e.g. American Association of Orthodontists, American Association of Endodontists...). We expect these new position papers and updates to be available from the Fall of 2010. The AAOMR is on record as recommending the use of cross-sectional imaging for dental implant placement planning, though the existing guidelines precede CBCT. Though I cannot state what the final product of the update on implant imaging might conclude, it is very likely that CBCT will be recommended for most, if not all, dental implant planning procedures. The age group for most dental ,implant placement cases, unlike orthodontic patients, is less susceptible to ill effects of radiation in the majority of cases. Further, without 3D imaging it is not possible to be certain of the anatomic variations possible that can impact on bone availability, or on the need to supplement bone by grafting when sufficient bone is not present where biomechanics indicate that an implant should be placed. My personal inclination is towards CBCT being the standard of care for placement of all endosseous implants used to replace missing teeth. 

Allan G. Farman

Allan G. Farman, BDS, PhD, MBA, DSc, Diplomate ABOMR

Prof. Radiology & Imaging Science
Univ. Louisville School of Dentistry: SUHD
501 South Preston Street,
Louisville, Kentucky 40292, USA 

Tel: +1(502) 852.1241
Fax: +1(502)852.1626


>>> Keith Horner <keith.horner at manchester.ac.uk> 01/06/2010 06:17 PM >>>


Dear Dr, Ganz,
you can find European (provisional) guidelines on CBCT use, including implants, on the SEDENTEXCT website:
http://www.sedentexct.eu/content/provisional-guidelines-cbct-dental-and-maxillofacial-radiology 
This also gives reference to European Association of Osseointegration Guidelines (Harris et al 2002).
There are U.S. guidelines, but I expect that one of my U.S. colleagues will fill you in on those, as I believe they are working on their own guideline document.
The European Assoc. of Osseointegration guidelines (Harris et al) are out of date, as they predate the ready availability of CBCT, and need revision badly. Our recent SEDENTEXCT guidelines were rather cautious about the use of cross-sectional imaging, being based upon the CBCT evidence available (we did not review CT material).
I feel (as a radiologist) that if a surgeon judges that a cross-sectional image is needed for implants then I can't imagine a situation where I would say no to the request. On the other hand, if a surgeon feels that he/she does not need cross-sectional imaging, I would not "push" CT/CBCT. I suspect that is a fairly common European view.
I hope that gives a European perspective for you. As I said, your US colleagues will no doubt fill you in on their views.
Good luck with your task force work.

Keith Horner
Professor of Oral and Maxillofacial Imaging, University of Manchester, UK.
Co-ordinator, SEDENTEXCT project.

Quoting SDGIMPLANT at aol.com: 

> To all:
>
> I have been asked to serve on a task force for the Academy of
> Osseointegration.  One of the topics are to review guidelines for 
> procedures related to
> implants and reconstruction - and of course now the use of  CT/CBCT imaging
> technologies.
>
> Are there specific guidelines set forth by the specialty of Oral &
> Maxillofacial Radiologists regarding the present use of CT/CBCT
> imaging for  dental
> implants, guided surgical procedures, or for maxillofacial surgery?
>
> Any help would be greatly appreciated.
>
> Thanks!!
>
> ________________________________________________________
> Scott  D. Ganz, DMD
> Prosthodontics, Maxillofacial Prosthetics & Implant  Dentistry
> President Computer Aided Implantology Academy: _CAI Academy_
> (http://www.caiacademy.org/)
>
> 158 Linwood Plaza -  Suite 204 Fort Lee, NJ 07024
> TEL: (201) 592-8888  FAX: (201)  592-8821
>
> Website:  _http://www.drganz.com/_ (http://www.drganz.com/)
> Computer  Aided Implantology Academy - _CAI  Academy_
> (http://www.caiacademy.org/)
> CT Imaging Forum:   _CT IMAGING  FORUM_
> (http://www.drganz.cncdsl.com/SIM_plant/index.htm)
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> (http://www.kineticguidance.com/)
>
>
>
>
>