A comparison of the diagnostic advantages of panoramic radiography and computed tomography scanning for placement of root form dental implants

TLDR

The study compared computed tomography to routine panoramic radiography for dental implant treatment planning. The authors validated the accuracy of CT and panoramic images in vitro, then compared CT plus panoramic versus panoramic alone in ten patients with compromised ridges, determining ideal implant length intraoperatively with direct digital radiography. CT combined with panoramic imaging increased dentists’ confidence, eliminated significant length underestimation, and matched planned to actual implant length, demonstrating CT’s value for maximizing implant length.

Abstract

This study evaluated the advantages of computed tomography (CT) in comparison to routine panoramic radiography for dental implant treatment planning. An in vitro validation study was performed to assess the accuracy of CT and panoramic radiography film images for measurement of anatomic structures and distances between anatomic structures. After correcting by a standard 25% magnification on the panoramic images, a significant difference in measurements was found between the CT and panoramic radiography images. Ten subjects requiring implants in compromised ridges were treatment planned with either CT and panoramic radiographs or panoramic radiographs alone. The ideal implant length was determined at surgery with direct digital radiography. The dentists were significantly more confident using CT and panoramic images than panoramic radiographs alone. Implant length treatment planned with panoramic radiography alone underestimated length significantly compared with the implant length determined to be ideal during surgery, whereas treatment planning with CT and panoramic radiography demonstrated no significant difference. The data indicate the CT may be of value in treatment planning for dental implants, especially when gaining maximum length is of critical importance.