title: Does cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images.
abstract: OBJECTIVE
  The present study was performed to compare the planning of implant placement based on panoramic radiography (PAN) and cone-beam computed tomography (CBCT) images, and to study the impact of the image dataset on the treatment planning.
  
  
  METHODS
  One hundred five partially edentulous patients (77 males, 28 females, mean age: 46 years, range: 26-67 years) seeking oral implant rehabilitation were referred for presurgical imaging. Imaging consisted of PAN and CBCT imaging. Four observers planned implant treatment based on the two-dimensional (2D) image datasets and at least one month later on the three-dimensional (3D) image dataset. Apart from presurgical diagnostic and dimensional measurement tasks, the observers needed to indicate the surgical confidence levels and assess the image quality in relation to the presurgical needs.
  
  
  RESULTS
  All observers confirmed that both imaging modalities (PAN and CBCT) gave similar values when planning implant diameter. Also, the results showed no differences between both imaging modalities for the length of implants with an anterior location. However, significant differences were found in the length of implants with a posterior location. For implant dimensions, longer lengths of the implants were planned with PAN, as confirmed by two observers. CBCT provided images with improved scores for subjective image quality and surgical confidence levels.
  
  
  CONCLUSIONS
  Within the limitations of this study, there was a trend toward PAN-based preoperative planning of implant placement leading towards the use of longer implants within the posterior jaw bone.
authors.affiliation: OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium. ; Department of Oral and Maxillofacial Surgery, University Hospitals, Leuven, Belgium.
authors.forename: Maria Eugenia
authors.initials: ME
authors.lastname: Guerrero
authors.affiliation: Master of Periodontology, Universidad San Martin de Porres, Lima, Peru.
authors.forename: Jorge
authors.initials: J
authors.lastname: Noriega
authors.affiliation: Master of Periodontology, Universidad San Martin de Porres, Lima, Peru.
authors.forename: Carmen
authors.initials: C
authors.lastname: Castro
authors.affiliation: OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium. ; Department of Oral and Maxillofacial Surgery, University Hospitals, Leuven, Belgium.
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
keywords: Cone-Beam Computed Tomography; Dental Implants; Radiography, Panoramic