CBCT - REDUCING RISK FOR DENTISTS PLACING IMPLANTS
By Charles A. Babbush, DDS., MScD.
Prior to the technological advances which brought us CBCT, radiographic techniques were all 2-D modalities; such as panoramic, periapical, occlusal, cephalometric radiographs etc, thereby limiting the practitioners diagnostic input, accuracy, and final outcome. Cone beam 3-D dental imaging (CBCT) brings the advantage of hospital-based CT scans into the dental practitioner’s office. Unlike the previously mentioned conventional two-dimensional radiographs, CBCT offers 3-D digital views of the oral cavity and face as well as the head and neck.
Software provided by manufacturers and vendors can enhance the gray scale as well as adding pseudo color to delineate both hard and soft tissue densities. These advances allow the dentist to clearly see such vital structures as the floor of the nasal cavity, maxillary sinuses, inferior alveolar canal etc., in addition to various soft tissue components. CBCT, in combination with the software, eliminates the guesswork that was previously necessary when trying to determine placement of an implant from a 2-dimensional radiographic image.
CBCT machines have a small footprint and are equivalent to a digital panoramic. The patient is either standing or comfortably seated within the scanner, eliminating the feelings of claustrophobia as with hospital scanners. Numerous images are obtainable for each patient, panoramic, axial, cross-sectional views as well as 3-D renderings. This allows for 3-D imaging of the intended implant site all within a fraction of a millimeter of accuracy.
For a practice that is already using digital radiography and rarely ventures into advanced procedures, a purchase of a CBCT scanner may not be necessary. A dentist who wishes to place implants may be concerned that in the early stages of implant placement, they may not have enough patients to offset the costs. Implant companies like Zuga Medical help such dentists by offering, in certain localities, access to CBCT systems that are provided at no cost to dentists who place their implants.
CBCT images can be forwarded to the dental laboratory who can use the information to fabricate surgical guides. While surgical guides are not a necessity, they do increase accuracy of placement, as well as help reduce potential complications. CBCT images are also useful in the planning stages and the surgical and prosthetic aspects of your cases.