title: Implant treatment planning regarding augmentation procedures: panoramic radiographs vs. cone beam computed tomography images.
abstract: OBJECTIVE
  To evaluate the impact of cone beam computed tomography (CBCT) imaging on treatment planning regarding augmentation procedures for implant placement.
  
  
  METHODS
  Panoramic radiographs and CBCT images of 40 patients requesting single-tooth implants in 59 sites were retrospectively analyzed by six specialists in implantology, and treatment planning was performed. Therapeutic recommendations were compared with the surgical protocol performed initially.
  
  
  RESULTS
  Bone height estimation from panoramic radiographs yielded to higher measures and greater variability compared to CBCT. The suggested treatment plan for lateral and vertical augmentation procedures based on CBCT or panoramic radiographs coincided for 55-72% of the cases. A trend to a more invasive augmentation procedure was seen when planning was based on CBCT. Panoramic radiography revealed 57-63% (lateral) vs. 67% (vertical augmentation) congruent plans in agreement with surgery. Among the dissenting sites, there was a trend toward less invasive planning for lateral augmentation with panoramic radiographs, while vertical augmentation requirements were more frequently more invasive when based on CBCT.
  
  
  CONCLUSIONS
  Vertical augmentation requirements can be adequately determined from panoramic radiographs. In difficult cases with a deficient lateral alveolar bone, the augmentation schedule may better be evaluated from CBCT to avoid underestimation, which occurs more frequently when based on panoramic radiographs only. However, overall, radiographic interpretation and diagnostic thinking accuracy seem to be mainly depending on the opinion of observers.
authors.affiliation: Department for Oral Surgery, Oral Radiology and Oral Medicine, School of Dental Medicine, University of Basel, Basel, Switzerland.
authors.forename: Dorothea C
authors.initials: DC
authors.lastname: Dagassan-Berndt
authors.affiliation: Department of Periodontology, Endodontology, and Cariology, University of Basel, Basel, Switzerland.
authors.forename: Nicola U
authors.initials: NU
authors.lastname: Zitzmann
authors.affiliation: Department of Periodontology, Endodontology, and Cariology, University of Basel, Basel, Switzerland.
authors.forename: Clemens
authors.initials: C
authors.lastname: Walter
authors.affiliation: Department of Oral Surgery (and Oral Radiology), University Medical Center of the Johannes Gutenberg, University Mainz, Mainz, Germany.
authors.forename: Ralf K W
authors.initials: RK
authors.lastname: Schulze
mesh_terms: D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous; D019250:Dental Implants, Single-Tooth; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D055815:Young Adult
keywords: cone beam computed tomography; dental implants; implant treatment planning; panoramic radiographs