Is a CT Scan Necessary for Dental Implant Treatments?

In order to place an implant in the patient's jaw, we need to assess several criteria at the location of the planned implant.  Some of the important factors may include: 1.  The patient's bone height

2.  The patient's bone width

3.  The proximity to the nerves in the lower jaw

4.  The proximity of the sinus cavity in the upper jaw

Using a 3D Cone Beam Scan (CT Scan) we can precisely analyze all of the above criteria and predetermine the exact size and location of the implant prior to the surgical placement.

Here is a screen capture of the planning process for two implants to replace two missing molars in our actual patient's lower jaw.  The red line below the two planned implants is a nerve in the lower jaw.  That nerve is often the limiting factor in the lower jaw where some implants for posterior teeth may be needed.

Proper use of technology helps ensure optimum results and safety of dental implant treatment.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

A Second Opinion on Dental Treatments - The Importance of the Quality and Type of Xray!

This past week a patient came to see me for a second opinion on her dental implant treatment.  She brought me a copy of the xray below, and asked me if I could advise her on whether or not she should do 1 or 2 implants to replace the teeth indicated by the green arrows.  She wanted to find out which of the following treatment options is better:

Note:  After this xray was taken, tooth (10) was extracted and a bone graft was done for this area by an oral surgeon.  In other words, tooth (10) currently is missing.

Plan A:  Extract the teeth labeled (8) and (9); place an implant at (8); do a bridge from position (8) to (11).

Plan B:  Keep teeth (8) and (9) as is, and simply attach a new tooth to the implant crown (11) to replace missing tooth (10).

Unfortunately, I could not answer her questions because the copy of the xray given to her was not useable.  Printed on regular white printer paper, the xray was dark and fuzzy. I could not clearly see the bone level at the location of these teeth. In fact, to identify the health of the existing teeth, other types of xrays would be necessary to have for our evaluation of the current condition.  In this case, xrays called periapicals (often abbreviated PA) would then allow us to not only evaluate the bone but also the root structure and internal condition of these teeth. For example, if the integrity of teeth (8) and (9) is normal, and a successful bone graft was done for (10),  then why would we want to remove 2 additional fully functional teeth?

We simply did not have enough information to determine an accurate evaluation based on this xray alone.  Furthermore, when it comes to implant treatment, accurate studies of this patient's bite also would be necessary in order to complete a diagnosis and treatment plan.

When asking for copies of your xrays, please remember to ask your dentist to provide you with quality copies. This most basic diagnostic tool must be clear and readable.

CT Scan and Dental Implant : High Standard of Care or Basic Requirement?

In my practice, this "High Standard of Care" is a "Basic Requirement". Dental Implants have become the preferred standard of care when it comes to replacing missing teeth in the mouth.  The advancement of technology has enabled dentists to accurately analyze the structure of the jaw and pre-plan for the implant work.

By using specialized software with images from a CT Scan of your dentition, I can analyze some important requirements which cannot be determined accurately with simple xrays alone:

1.  Bone density

2.  Bone thickness

3.  Bone height

4.  Proximity to nerve canals and the Sinus

5.  Proximity to/ angulation of adjacent tooth root

With the above analysis, I can choose the right implant size before going into the surgery.  The advanced treatment planning and analysis help prevent unexpected complications such as damage to vital nerves or impingement on the Sinus.

Here are some images of an analysis of a CT Scan for Dental Implants treatment:

One should never compromise a life-long restoration by choosing an implant treatment that has not been carefully planned out.  This is particularly crucial in the esthetic zone such as your front teeth where lack of planning can produce an unfavorable esthetic result.

Thank you for viewing my post, and please let me know if you have any question.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.