CT Scan for Dental Implants

Dr. Scott Ganz believes that “those practices where a relatively high volume of implants, will soon witness the appearance of CT machines…”. Furthermore, “One of the problems I see is that there are many formulas or cook-book approaches to treatment planning for implants. You know, like so many implants are required to replace so many teeth or how many implants are necessary to support a particular kind of prosthesis.” Read more of his thoughts on CT Scans for dental implants by clicking here for Part I or clicking here for Part II. Feel free to post your thoughts on his interview, by adding your comments below.

13 thoughts on “CT Scan for Dental Implants

  1. I have been using CT scans and stents for virtually every implant I have placed since about 1995. I think the key reason why surgeons do not see the value in CT scans in placing implants is the problem with transferring the data they see on the CT scan to the mouth in an accurate manner. Angulations and position of placement can be estimated with software but transferring that data to the mouth accurately is still done by an estimate. I was glad to finally see the ability to correlate a stent to the CT scan commercially at the SF Osseointegration convention. I have been using CT scans and Stents with “tube” markers since about 1995 and was using stents with “guide tubes” since 1993 to accurately place implants in 3 dimensions while also controlling depths. I would not place an implant without them. They not only allow accurate implant placement in 3 dimensions but also allows pre-planning of abutments, restorations and aesthetics. They also allow placement of the longest implants possible in a given situation by allowing closer placement tolerances to critical structures (ie. nerves, the sinus and adjacent roots. I believe this greately improves success rates from a restorative as well as surgical point of view.

  2. Great comments. Glad to hear that you believe that CT imaging “improves success rates from a restorative as well as surgical point of view.” Without 3D imaging we are still guessing… and I agree that most Oral Surgeons seem the reluctant to use CT for the reasons you state, and also because they were never trained with interative CT based treatment planning concepts. The AO Meeting in SF was where Michael Klein introduced the “missing link” the connection between the CT imaging data created with the “plan” and the surgical template. As Chairperson for Technology Day, I tried to focus the day on this technology, but at that time the interest just was not there, and the day was cancelled. I am happy to see the industry moving in the right direction now. Glad to hear that you are a long time convert!

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  4. I believe that the use of a CT is very important, I send most patients for a CT to a facility that specializes in the procedure. I would not own a CT in my facility for liability purposes and have all images read by a oral radiologist. The CT is of benefit but the liability of owning a CT is of no interest to me. really think, even though the price is affordable for the scanner is it really worth it? Who do the CT companies suggest should take the CT, read the CT? who do the courts believe should take the CT read the CT? Could you read the CT for a blockage in the carotids? hope so, it is imaged when you scan!

  5. Hellow I am doctor rdiologist in computed tomography deparment in Greece . Recently we put a Dental CT software . I would ask to you to tell me what is the role of doctor radiologist . What must i know . Which books must i study .
    Thank you very much .

  6. I purchased recently a dental CT scanner (Prexion). I am a general dentist and am looking for some help on Informed Consent forms for GP dental offices. My primary reason to purchase a CT scanner is for Implant treatment planning, how do I cover my liability for other associated areas? Is there a ADA approved form? Thanks in advance

  7. I’m going for a CT scan soon, as I’m getting four dental implants on the floor of my mouth. Is this a big, long procedure, and how much does it cost? I haven’t discussed this with my dentist yet.
    Please email me; I’m stressed out by all this.

  8. Linda, the CT scan using dental scanning equipment such as the I-Cat is just as easy and stress-free as a normal panoramic x-ray. You sit or stand at the unit, the technician gets you positioned properly, then the scan is taken. Most units take only 20 seconds for the whole thing while you just hold still. No stress, no strain, and in just a few minutes your dentist will have a really nice 3-Dimensional picture of whatever structure he wants to look at. NO STRESS, I promise!

  9. The primary question every dentist has in mind is the investment of CT machine in clinic.The technology of using has no second answer.It is THE thing in implant practice.So can Dr.Ganz answer following querries?He is the authority as far as I know so I am asking him.Others can also place inputs.
    Is ADA or competitive governing body considering use of CT scan in every implant case a MUST?
    Can every dentist read every CT scan?
    Or does it require further training?

  10. Dear Dr Gavridakis,
    The DCNA (Dental Clinics of North America) of OCt 2008 would be extremely useful as , although concise, the whole edition is devoted to “Contemporary Dental & Maxillofacial Imaging”.
    There are several other textbooks that give out useful info on the subject as well.
    One of the most comprehensive sources of the specific information that you are looking for may be accessed from the Abstracts of “The 1st International Congress on 3-Dimensional Dental Imaging” held in 2007.

  11. The nice thing about liability and the Prexion unit is it’s limited focal size. After some extra education, pathology is usually not too difficult to see. I send cases of concern to a local dental pathology department for their interpretation.

    NG, if you didn’t learn it in dental school, which you didn’t, then you need some extra training. As far as liability and what one MUST do, that is more a question of standard of care. That means it depends on what others in your area are doing. In my area treatment aided by CT scans is becoming more common. I have a CT, a periodontist and an oral surgeon within two miles of me have CT’s and there is a local radiology center providing this service too. Given this information it won’t be long before an attorney argues that a dentist was negligent for not obtaining a scan before treatment.

    As for surgical guides, I think it’s better in theory than in practice. I think the process of designing the guide is more valuable than the guide itself. I began making my own guides before I made guides from CT’s and software. My guides were always right on, whereas the guides fabricated through virtual placement were less predictable. Now on larger cases I sometimes use virtual placement to familiarize myself with the case, but don’t bother making the guide.

    I purchased the CT primarily for implant cases, but I found so many general dental issues that I now include it as part of my FMX. I also say that the argument about radiation exposure vs. the value of a scan is a non issue. The CBCT exposure is so low that for me it is clearly worth it.

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