What is a dental CT scan?

What is a dental CT scan?

A CT (computed tomography) scan is a noninvasive medical test that uses special X-ray equipment to produce multiple images or pictures of the inside of the body and a computer to join them together in cross-sectional views of the area being studied. Traditional panoramic X-rays performed by dentists provide only a limited two-dimensional view. While they can show the height and contour of the jaw bone, they give no indication of the bone width and density and may distort the location of the alveolar nerve. State-of-the-art, three-dimensional dental CT imaging takes the guesswork out of implants. This quick and safe diagnostic imaging exam produces life-like spatial views of the mouth that let the surgeon determine pre-surgically if a patient is an implant candidate. With 3D imaging, a surgeon can proceed with confidence, knowing the amount of bone a patient has, the distance to the alveolar nerve and the exact angles to situate the implant.

Why a CT Scan is Necessary Prior to Having Dental Implants?

A CT scan is the most effective diagnostic procedure to establish the patient’s suitability for dental implants, as it provides a 3D computed tomography (CT) image of the lower area of the skull. From the image we are able to determine the exact bone depth, width, density and condition, along with the precise position of your nerve canal and sinus cavity. This significantly decreases risk to the patient and increases implant success.

When should I consider dental CT imaging?

Dental CT imaging is used when patients are being fitted for implants. The more information a surgeon has about the anatomy of the patient’s mouth before a dental implant, the better the outcome. Important measurements for the surgeon to know include the width and density of the jawbone ridge in order to assess implant feasibility and the exact placement of the alveolar nerve in order to prevent painful nerve damage. Dental CT imaging can also help visualize nerve location prior to wisdom tooth extraction.

What Type of Image will I Have at My Appointment?

While individual problems are presented by each patient, most patients will benefit from a traditional panoramic (the exact type of image will be determined based upon your presenting clinical problem). Traditional panoramic films are used most often for obtaining screening views of the upper and lower jaw prior to performing wisdom tooth removal or for evaluation of other problems related to the jaws (including  placement of dental implants). Panoramic images allow obtaining of a large amount of clinical information for relatively low radiation dosage to the patient.

Problematic however: the Panoramic x-ray is a 2 dimensional image while the jaws and facial skeleton are 3-diminsional structures. Therefore, the Panoramic x-ray is unable to provide all the information sometimes required. As a commonly encountered example, the anatomy of the inferior alveolar nerve (and its relation to the roots of the wisdom teeth) is an important consideration during the evaluation process of wisdom tooth surgery. Its relation to areas of the lower jaw in cases of dental implant planning are also critical. In addition, the evaluation of sinus anatomy (in relation to the upper jaw bone) is often less than ideal with a Panoramic x-ray.

Why can’t you use the Panoramic X-ray my general dentist took?

Many times these film images are of inadequate orientation or quality (particularly when an image has been transferred to paper) and critical areas of anatomy cannot always be adequately discerned in order to make an informed decision. When transferring radiographic data from electronic media to paper it can result in significant loss of image resolution and clarity. We can use a current panoramic x-ray obtained by your general dentist for certain surgical procedures; however, complex oral surgical cases and evaluation for placement of dental implants require an image to be obtained in our office at the day of your consultation.

Do I need a Panoramic or Cone-Beam 3D Scan or Both?

Goal: It is the desire of our doctors to obtain the highest quality needed clinical/x-ray data in the safest manner (lowest radiation dose) and lowest cost to the patient. Having stated this, please understand the following factors:

1)      Individual anatomy varies from person to person

2)      The Cone beam scan is more expensive than screening panoramic view, but the cone beam scan provides a vastly larger amount of clinical data upon which to make clinical decisions. Most patients will benefit from an initial screening panoramic film. In situations where the anatomy suggested from this film is uncomplicated, this may be the only images required. Some patients, based upon the information obtained from the panoramic film, will then benefit from an additional cone beam scan in order to discern more detail. Some patients should (or may choose to) proceed directly with a cone-beam scan (skip the Panoramic): i.e. implant patients, patients with complex facial skeletal problems, patients in whom a previous film has suggested close root/nerve anatomy or patients who simply choose to proceed directly to cone beam scan). Again, radiation dose with a cone beam scan is just slightly higher than a panoramic film. Some patients may choose to proceed directly with a cone-beam scan and skip the Panorex film. Given the current capabilities and low dosage of cone beam technology, this is sometimes a reasonable option

Dr. Lee has made an investment in providing the convenience and safety of digital cone-beam imaging software to evaluate your 3D scan. We have chosen to utilize an adjustable field of view cone beam scanner. This unit provides best-rated, quality images being provided.

What will my initial dental implant consultation consist of?

The initial appointment is reserved for Dr. Lee or Dr. DeFelice to learn your goals for restoring missing teeth. They will also review your medical and surgical history to ensure you are an appropriate candidate for this procedure. They will conduct a thorough oral examination and review with you the panoramic image that was taken in our office. A preliminary idea as to how many implants are needed and if a bone graft should be considered can be discussed at this time. Usually, the doctor will need additional information and he will discuss with you what other images may be needed or if a consultation with your restorative dentist is needed. We can obtain the CT scan in our office the day of your initial consultation. Your surgeon will be able to review the scan and prepare your treatment plan to discuss with you at your second appointment.

The second meeting with your surgeon will consist of reviewing the additional images, CT scan for example, and discussion of your treatment plan. Your surgeon will review with you the final treatment recommendations, any alternatives to treatment, and all risks and benefits associated with the procedure. You will meet with our treatment coordinator who will give you a break down of the associated fees in writing. She will also share with you any benefits your insurance plan will be extending for your surgery. You can then schedule for your procedure.

While we understand that these issues may sound somewhat complicated, we do feel it is important for those patients who have questions related to their unique imaging needs be aware of the issues involved in the decision-making process. Please don’t hesitate to discuss your individual situation with us!