CT Scan for Dental Implant: When is the Best Time to Get One?
Bob asks:
I understand that the best time for a CT scan or Cone Beam is right after the teeth are pulled and before the immediate implants placed - so that any bone "loss" / problems with the extractions will be noticed - as opposed - to getting a CT scan first and then "later" finding the appropriate dentist. However, I feel that getting the CT-scan first will allow me to get a firmer estimate for the entire implant operation first, which will aid me in choosing the proper dentist.
Is there "really" a risk that teeth extraction will result in bone loss that will be occuring "after" the CT Scan was done and then an implantologist shopped for? I would NOT be putting off the procedure more than 4-6 weeks after ANY CT scan
Hi Bob,
I always prefer to obtain the Scan or Cone Beam prior to formulating and presenting a treatment plan. This allows me not only to determine what I can do, but also what I can't do.
The pre-treatment CT scan or Cone Beam affords me the opportunity to present as precise a treatment plan as possible to my implant patients, and thus gives my patients the best information to make an informed decision on any treatment I propose.
It is correct that there is always some bone loss following any surgical procedure or extraction, and there are some times when a Cone Beam during or following extractions and treatment is appropriate. In those few cases where crucial anatomical structures are involved and the margin of safety around that structure is small, the benefits of obtaining pre-surgical and intra-surgical scanning far outweighs the extra cost and radiation exposure.
I try to utilize my Cone Beam machine judiciously, but having a Cone Beam machine in-office during a procedure, allows that extra margin of safety in those rare cases where a second scan is necessary.
I hope this is helpful and good luck with your case.
Dr. Brook
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Followup on Dr. Brook advice on Cone Beam
You mentioned pre-surgical and intra-surgical scanning. This is something I want to clarify. I think I need a cone-beam scan now - for treatment planning and for Dentist shopping [provide several dentists with the cone-beam scan].
IF - it is determined that 2-3 months after the initial cone-beam is taken AND the Dentist feels that he needs another cone-beam taken after the actual extractions - am I reading you correctly that in cases where the dentist feels he needs further information after extraction - you feel that that need for further information outweighs the added radiation exposure of a 2nd cone beam ?
I am hoping that cone-beam scanning uses a low enough radiation dose - that 2 scans within a 3 month window would not be problematic under sensible radiation guidelines.
I am not concerned with the added cost.
Thank you for your comments.
Most all new cone beam
Most all new cone beam machines use a specific focal area for radiation exposure, which means only the area in question would be exposed to radiation as opposed to exposing the entire head like you may have assumed. This will expose you to less radiation than a traditional panoramic shot. Not to mention the data that is provided to a dentist from these images could possibly save you from a much, much larger complication.
As a patient I would only want a cone beam used on me in any extraction or implant case.
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