[Oradlist] Guidelines for CT/CBCT

[Ann Wenzel]

Another voice from Europe:
it would be unfortunate if new guidelines are too bombastic on demands for 
CBCT before any implant placement. Following the implant litterature, we are 
aware of the trend to install an implant immediately after extracting the 
tooth - or if the tooth had periapical infection - a few weeks after. This 
may become  the standard of care at least in some regions of the jaws. In 
these cases the bone is certainly available and no cross-sectional imaging 
needed.
In my university the students are doing implant installation as part of 
their curriculum with the aid from the surgeons, and we do no 
cross-sectional imaging in connection with this. If in a few cases the 
surgeon lacks bone when opening up, they have ways to take care of this.
Maybe the question should be more about who is installing implants ...

all the best
Ann Wenzel
Aarhus
Denmark


----- Original Message ----- 
From: "Allan G Farman" <agfarm01 at louisville.edu>
To: "Oral Radiology Discussion Group" <oradlist at lists.ucla.edu>
Sent: Thursday, January 07, 2010 1:05 AM
Subject: Re: [Oradlist] Guidelines for CT/CBCT


> 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)
>> New Course Offerings: _www.kineticguidance.com_
>> (http://www.kineticguidance.com/)
>>
>>
>>
>>
>>
>
>
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