[Oradlist] Guidelines for CT/CBCT
SDGIMPLANT at aol.com
SDGIMPLANT at aol.com
Thu Jan 7 14:55:30 PST 2010
Hello Ann -
Thank you for your thoughts. While I certainly understand your
suggestion, I agree with Allan when he suggests that CBCT is important as a
diagnostic tool for dental implant placement - due to the incredible variation in
bone and root anatomy and clinical presentation.
That stated, you are correct that the person placing the implant should
have good training, and experience. As it is important to handle all
situations which may arise, with a proper clinical / surgical skill set, wouldn't
you agree that it is better to have an understanding of the anatomy prior
to the scalpel ever touching the patient? In this way, we can plan ahead,
and have everything ready, without the guesswork, and full knowledge and
disclosure to the patient of what will be done. In my opinion, CT and CBCT
imaging helps clinicians to appreciate these anatomical variations, as each
patient is unique, allowing us to have a sound basis for our decision-making
I, and perhaps many on this list, can cite a myriad of what appeared to be
simple, single tooth cases - immediate extractions even, where the bone
topography was completely different that what appeared on clinical exam,
panoramic or periapical radiograph. In fact sometimes the single tooth
application presents the most challenge - especially in the esthetic zone with
convergent roots, or facial concavities.
Perhaps discussions like this help us to understand what type of
guidelines should be recommended - based upon sound clinical judgement which relates
to the treatment at hand. The end result should be a more favorable
outcome for the patient, the surgeon, and the restorative dentist.
Best regards to Denmark!
Scott D. Ganz, DMD
Prosthodontics, Maxillofacial Prosthetics & Implant Dentistry
President Computer Aided Implantology Academy: _CAI Academy_
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_
CT Imaging Forum: _CT IMAGING FORUM_
New Course Offerings: _www.kineticguidance.com_
In a message dated 1/7/2010 2:52:54 A.M. Eastern Standard Time,
awenzel at odont.au.dk writes:
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
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
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
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