The radiographic assessment of implant patients: decision-making criteria.

TLDR

Panoramic radiography is the standard low‑dose imaging modality for implant treatment planning, providing the best survey. The study proposes indications for the most common imaging modalities in implant dentistry based on clinical need and biologic risk. The authors calculated biologic risk through dose measurements, used periapical radiographs to detail panoramic findings, applied film tomography or CT only in special cases—film for small regions and CT for the full maxilla or mandible with dose‑reduction—and considered intraoral radiography the standard follow‑up exam, especially for anterior maxillary implants or research. They found that a periapical radiograph carries 20% of the risk of a panoramic radiograph, a panoramic radiograph and four conventional tom.

Abstract

Indications for the most frequently used imaging modalities in implant dentistry are proposed based on clinical need and biologic risk for the patient. To calculate the biologic risk, the authors carried out dose measurements. They demonstrated that the risk from a periapical radiograph is 20% of that from a panoramic radiograph. A panoramic radiograph and a series of 4 conventional tomographs of a single-tooth gap in the molar region carry 5% and 13% of the risk from computed tomography of the maxilla, respectively. Panoramic radiography is considered the standard radiographic examination for treatment planning of implant patients, because it imparts a low dose while giving the best radiographic survey. Periapical radiographs are used to elucidate details or to complete the findings obtained from the panoramic radiograph. Other radiographic methods, such as conventional film tomography or computed tomography, are applied only in special circumstances, film tomography being preferred for smaller regions of interest and computed tomography being justified for the complete maxilla or mandible when methods for dose reduction are followed. During follow-up, intraoral radiography is considered the standard radiographic examination, particularly for implants in the anterior region of the maxilla or for scientific studies. In patients requiring more than 5 periapical images, panoramic radiography is preferred.