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Comparison of X-ray Dose
Digital Digital PanoramicPanoramic
4.7 4.7 –– 14.5 14.5 µSv
PanoramicPanoramic
10 10 –– 15 15 µSv
Highest Film Highest Film PanoramicPanoramic
26 26 µSv
Full mouth seriesFull mouth series
150 150 µSv
Medical CTMedical CT
1200 1200 –– 3300 3300 µSv
● Radiation from other sources
● Daily background 8 µSv
● Commercial long haul flight
6 µSv/hr
● Lower limits occupational
exposure 20,000 µSv/yr
Cone Beam CTCone Beam CT((EPX-IMPLAEPX-IMPLA))
25 ~ 60 25 ~ 60 µSv
Dr. Sharon Brooks, Dept. of Radiology, University of MichiganDr. Stuart White, Dept. of Radiology, UCLA
Necessary of CT Diagnosis
If patients move out from the focal trough, image will be changed as extension
or reduction. There are much error in panoramic shot. - Toward to Buccal : Reduction.
- Toward to Lingual : Extension.. ReductionReduction
ExtensionExtension
Necessary of CT Diagnosis
● Insufficient bone & invisible canal from the above canal
● Insufficient bone underneath the sinus
● Bone absorption / Ridge shape
● Nasal cavity / Incisive canal / Sinus
Define Oral Anatomy11
Accurate treatment plan before surgery22
Increasing patients’ agreement of treatment plan44
● Reference from exact position of impacted teeth
33 Saving time from diagnosis to surgery
Average Distortion Maximum Distortion
3.0 mm 7.5 mm
1.0 mm 5.5 mm
0.2 mm 0.5 mm
PanoramicPanoramic
PeriapicalPeriapical
CComputedomputedTTomographyomography
Necessary of CT Diagnosis
Necessary of CT Diagnosis
Panorama : 13.5mm , 10.0mm
CT : 12.96mm, 9.60mm Exact Length
Panorama vs CT
1st : + 0.54mm
2nd : + 0.40mm
* A panorama image must revise as much as about -20% down because of the extension rate.
Bone Width Bone Quality
- +
- +
++++ ++++
PanoramicPanoramic
PeriapicalPeriapical
CComputed omputed TTomographyomography
Necessary of CT Diagnosis
1-5. Necessary of CT Diagnosis
Need to check the depth and position of mandible bone to figure out how to implant.
Looks OK with 2D on Panoramic View Looks OK with 2D on Panoramic View But you can image by using Cross Sectional View on 3D But you can image by using Cross Sectional View on 3D
Necessary of CT Diagnosis
In the view of panorama, mandible darkness is as shown cortical bone.
Therefore, even the knife edge area can be measured as same density.
Necessary of CT Diagnosis
Absorption of bone can be diagnosed by using 2D, 3D and 360˚ rotation.
SagittalSagittal 3D-Zoom3D-Zoom
AxialAxial 3D-Rotation3D-Rotation
Inf. Alveolar N. Maxillary Sinus
++ ++
+ +
++++ ++++
PanoramicPanoramic
PeriapicalPeriapical
CComputed omputed TTomographyomography
Necessary of CT Diagnosis
Necessary of CT Diagnosis
When implant operate they can measure exact length of operation area.
Actual LengthActual Length
Necessary of CT Diagnosis
Only Panoramic view is invisible because palatal bone is overlaid on the maxilla.
The position and form of the maxillary will be diagnosed as shown as 3D Image.
CT can figure it out easily,
when we use cross sectional view
It can show indefinite bone, because of maxillary cyst.
Necessary of CT Diagnosis
Incisive N. Mylohyoid ridge
- -
- -
++++ ++++
PanoramicPanoramic
PeriapicalPeriapical
CComputed omputed TTomographyomography
Necessary of CT Diagnosis
Appearances of CT Models
EPX-IMPLAEPX-IMPLA
Clinical Cases
Impacted Teeth of Mandible
Impacted Teeth of Mandible
Mandible 3rd Molar (Hard case)
Impacted Teeth of Mandible
3rd molar in the view of axial (check the root direction)It toward to Buccal side unusually
LingualLingual
BuccalBuccal
Impacted Teeth of Mandible
Check the position of 3rd molar with canal
BuccalBuccal
FacialFacial
LingualLingual
Impacted Teeth of Mandible
Coloring on the mandible canal
Impacted Teeth of Mandible
Check position of canal (Vertical, Horizontal)
What are the advantages of CT equipment
Having CT is not only modernized treatment. Also,
satisfaction of what patient
needs.
Having CT is not only modernized treatment. Also,
satisfaction of what patient
needs.
Comprehension of PatientsComprehension of Patients
Increase Acceptance RateIncrease Acceptance Rate
Enable Predictable Rx.Endodontics, Surgical Extraction
Extract or not, Periodontal Treatment
Enable Predictable Rx.Endodontics, Surgical Extraction
Extract or not, Periodontal Treatment
Happy Implant Dentistry
Increase IncomeIncrease Income
Conclusion
