People sometimes ask why we need to use a CBCT scan for placing implants when years ago it was never used. I always use a CBCT scan in planning and treatment for dental implants and it has become the gold standard for optimal implant placement. A CBCT, also referred to as cone beam volume CT, is medical imaging technique consisting of digital x-ray computed tomography where the x-rays are divergent, forming a cone. It is basically a 3D X-ray that shows the height, width, density and thickness of bone. I can also see clinical landmarks and it allows for precision planning. The actual CBCT scan takes approximately 20 seconds. Click here to find out more about the radiation levels from different types of xrays. A CBCT scan is approximately 100 times less than a regular CT scan.
Success or failure of implants depends on the health of the person who is receiving it, drugs which impact the chances of Osseo integration and the health of the tissue in the mouth. The amount of stress that will be put on an implant in the future during normal function is also evaluated. Planning the position and number of implants is key to long-term health of the prosthetic since bio mechanical forces created during chewing can be significant. A CBCT scan gives even more depth, detail and topography.
The position of implants is determined by the position and angle of adjacent teeth and health and density of the bone, and other factors. Long-term success of Osseo integrated dental implants is usually predetermined by healthy bone and gingiva. Since both bone and gum can atrophy after an extraction, pre-implant placement procedures such as sinus lifts or gingival grafts are sometimes required to re-create ideal bone and gingiva.
Implantologists back in the day used to place implants without the scans because the technology had not been developed. One or two dimensional X-rays would show the height but not thickness or density. Imagine trying to put a fence post in the fround that is covered in grass. If you don’t know if the soil below is gravel versus solid Adobe, your couldn’t plan what tools or materials to use or what size and depth of a post you would need. How you place it and even the expected outcome or long term success will be different depending on those factors.
As I have said before, I like all of my cases to succeed. Therefore, I always evaluate a case for good bone availability before starting by using CBCT technology and a visual exam. It doesn’t make sense to put someone through the stress of a procedure if I know the end result will be just OK or poor.
What questions do you have?
I invite you to send me a message or question. If you or someone you know is thinking of getting dental implants, we do offer complementary dental implant consultations.