Q. I have been placing implants successfully for the last ten years and have always used panoramic x-rays to prepare a treatment plan. I’ve been told CT scans are far more precise and produce a 3D image allowing for accurate preparation in more difficult cases. However they are a lot more costly, is it worth the extra cost?

A.Ct scans are the most innovative and highly developed X-ray technology for dental implant treatment. They present a 3-Dimensional image shown on computer with an implant preparation program. There are different packages on the market but inevitably they all provide the same information and reach the same target. The scan can also show visible reconstruction and you can measure different aspects such as bone density, height and width. It also allows you to locate anatomical sights like the mandibular nerve, and position virtual implants to demonstrate possible sizes and angles. However the amount of radiation exposure is greater from a CT scan in comparison to other X-ray technologies, therefore its most practical for planning complicated cases where sinus lifts or bone augmentation is needed. OPGs are the most frequently used X-rays when preparing for implants and are valuable for identifying anatomical sights, pathology, and preliminary information of bone density. However there is certain information an OPG just can’t provide that is needed for more difficult cases, like 3D imagery, and anatomical limitations for example maxillary sinus involvement, height and width of bone, buccolingual measurements, concavities and inferior alveolar nerve proximity.