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cone beam – international magazine of cone beam dentistry

I 03 editorial _ cone beam I cone beam4_2015 _Our patients come to us for a variety of different needs, and as practising clinicians, it is our obligation to properly diagnose and recommend an appropriate plan of treatment. Until recently, 2-D periapical or panoramic imaging modalities were utilised to diagnose periapical pathology, tooth decay, periodontal disease and root morphology for endodontic treatment, restorative den- tistry,andassessmentofpotentialimplantreceptorsites.Theseconceptswereacceptedandwidely taughtbyradiologydepartmentsindentalschoolsworldwideasconventionaldiagnosticdentistry. However, with the advent of CT, and now CBCT, it has become increasingly evident that 2-D imaging modalities may not provide the most accurate assessment of the region of interest. As an example, on a panoramic image of the mandibular symphysis, we may be able to determine the height of available bone, but we cannot ascertain the width, contour or quality of the bone for the potential placement of dental implants. The course of the mandibular canal is essential to avoid damage resulting in irreversible paraesthesia. In the posterior mandible, there is often a clearly defined lingual concavity that if not visualised could lead to potential complications. A few more considerations to think about: How important is it to know the actual width from thelateraltothemedialwallofthesinustodeterminethevolumeneededtofillthesinustocreate thefoundationforimplantplacement?Intraosseousvesselsoftenresidewithinthelateralwallsof the maxillary sinus and these cannot be determined with 2-D imaging modalities. It is important that they be visualised when contemplating a sinus augmentation procedure. Can the contour of thefloorofthesinusbeproperlyappraisedwhenevaluatingtheposteriormaxillaforatranscrestal approachwithsimultaneousimplantplacement?Whataboutthepresenceofseptainthemaxillary sinus? Septa are often problematic when they hinder the proposed treatment. Their presence and location cannot be determined from any 2-D radiography and may play a significant role in the long-term success of treatment. Readersofpastissuesofourconebeaminternationalmagazineofconebeamdentistryhave been exposed to a variety of clinical examples of how 3-D imaging modalities have been utilised in daily practice. However, there is one aspect of CBCT that may represent the most important reason thatcliniciansneedtomovefrom2-Dtotheworldof3-Dimaging:theabilitytovisualiseanatomy in 3-D provides clinicians with an unprecedented appreciation that each patient is different. Each patient’s anatomy is revealed to be individual and separate from another person’s mandible or maxilla,eachtooth,eachalveolus,eachinferioralveolarnerveormaxillarysinus.Thatindividuality is so very important for clinicians to understand prior to commencing treatment and should serve as ample justification to enhance our diagnostic acumen to improve clinical outcomes and reduce complications for our many patients. Please enjoy our latest issue, with our compliments. It is our mission to continue to present valuablecontentregardingthiswonderfulimagingmodalityandancillaryproceduresthatbenefit from 3-D imaging technology. If you pick up one pearl from the articles enclosed, spread the word, tell your friends and share with your colleagues. Thank you! Dr Scott D. Ganz Editor-in-Chief Every patient is different The value of cone beam 3-D imaging Dr Scott D. Ganz

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