title: Is Cone-Beam Computed Tomography Always Necessary for Dental Implant Placement?
abstract: OBJECTIVE
  The use of cone-beam computed tomography (CBCT) for evaluation of patients for dental implants has gained considerable popularity. This retrospective cohort study was designed to determine whether using a clinical examination and a panoramic radiograph (Panorex) for implant selection and determining the need for bone grafting would be comparable to using CBCT in routine implant cases.
  
  
  METHODS
  Implant size and need for bone grafting were initially determined in 82 patients using a panoramic radiograph and clinical examination. These patients subsequently underwent CBCT and their treatment was re-planned by the same surgeon using Simplant treatment planning software (DENTSPLY Implants, Mölndal, Sweden) in addition to clinical examination. The length and width of implants selected by each method and the need for bone grafting were recorded and the results were compared statistically with each other and with the actual treatment subsequently rendered.
  
  
  RESULTS
  The Panorex method and the CBCT method accurately predicted implant width to within 1.5 mm of the implant actually placed in 100% of cases and length to within 1.5 mm in more than 95% of cases. For bone graft prediction, the results indicated that neither the Panorex method nor CBCT method differed substantially from the actual treatment rendered.
  
  
  CONCLUSIONS
  The results of this study indicate that the CBCT is more accurate in predicting implant length and width and the need for bone grafting procedures. However, for routine unguided implant placement in sites where anatomic structures and bone grafting are not a concern, the use of a panoramic radiograph could be adequate for determining the length and width of the implant.
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA. Electronic address: grdeeb@aol.com.
authors.forename: George
authors.initials: G
authors.lastname: Deeb
authors.affiliation: Chief Resident, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Ludmils
authors.initials: L
authors.lastname: Antonos
authors.affiliation: Student, School of Dentistry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Tack
authors.affiliation: Assistant Professor, Department of Research Administration, Virginia Commonwealth University, Richmond, VA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Carrico
authors.affiliation: Professor Emeritus, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Laskin
authors.affiliation: Assistant Professor, Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Janina Golob
authors.initials: JG
authors.lastname: Deeb
mesh_terms: D016025:Bone Transplantation / Q000379:methods; D054893:Cone-Beam Computed Tomography; D003757:Dental Implantation / Q000379:methods*; D015921:Dental Implants; D006801:Humans; D011862:Radiography, Panoramic; D012189:Retrospective Studies
chemical_list: D015921:Dental Implants