A panoramic X-ray is a basic dental imaging method that shows all the teeth, both jaws and the jaw joints in a single two-dimensional image, and is used at the first examination. Cone beam computed tomography (CBCT) examines the teeth and jaws in three dimensions and, particularly in implant planning, allows the height, width and density of the bone and its distance from nerves and sinuses to be measured.
- Panoramic X-ray: all teeth and jaw structures in one image
- CBCT: 3D measurement of bone height, width and density
- Nerve and sinus distances assessed before implant surgery
- Lower radiation dose than medical CT
Treatment process
Examination
After a clinical examination, the dentist decides which imaging is needed; a panoramic X-ray is usually the first step.
Protection
A lead apron is placed on the patient before any X-ray is taken.
Imaging
A panoramic X-ray, or a 3D CBCT scan where necessary, is taken.
Assessment and planning
Bone measurements are made on the images, nerve and sinus distances are identified and treatment is planned accordingly.
What does a panoramic X-ray show?
A panoramic radiograph is a two-dimensional X-ray usually taken for initial diagnosis, and it provides essential information at the first examination. It is particularly useful for assessing:
- Decay between the teeth
- Bone loss around the teeth
- The position of wisdom teeth
- Abscesses and cysts
- The jaw joints
- In children, the position of baby teeth and developing adult teeth
What is a dental CBCT scan?
Cone beam computed tomography (CBCT), also known as dental volumetric tomography, creates a 3D model and cross-sections of the jawbone and teeth, revealing details that cannot be seen on two-dimensional X-rays.
This allows precise, treatment-specific measurements in oral surgery, implantology, periodontics, endodontics and orthodontics.
Why CBCT matters in implant planning
A panoramic X-ray gives only a rough idea of the implant length that can be used; it provides no information on bone thickness or density, and therefore on the implant diameter and type. Where needed, a 3D scan makes it possible to:
- Set a safe distance between the implant and the nerve
- Measure the bone that will surround the implant, reducing the risk of future bone loss
- Measure the distance to the sinus and assess whether a sinus lift is needed
- Determine whether a bone graft is required where the bone is thin
- Identify whether more advanced surgery is necessary
Planning on the patient's 3D model and cross-sections considerably reduces the risk of complications and unwanted outcomes.
Radiation and safety
Dental volumetric scanners use a much lower radiation dose than conventional medical CT; the difference varies with the device and the field of view, but is roughly 70–90%. This is why CBCT has quickly become a widely used imaging method in dentistry.
A lead apron is the most effective personal protection against X-rays and is always placed on the patient before imaging. Scans are taken only when they are needed for diagnosis and treatment.
Guided implant surgery planned around the final teeth
From an implant plan made virtually on the CBCT data, a patient-specific implant guide (surgical template) can be produced. The position of the teeth in the future prosthesis is decided first, the implants are planned accordingly, and the guide is used during surgery. In other words, the implants are placed to suit the prosthesis rather than the other way round, which helps minimise fitting problems later on.
In suitable cases, these guides also allow flapless surgery, without opening the gum and without stitches. For patients considering dental treatment in Denizli, Turkey, suitability for guided surgery is decided after the CBCT assessment.
Frequently asked questions
What is the difference between a panoramic X-ray and a CBCT scan?
A panoramic X-ray shows the whole mouth in one two-dimensional image and is used for an overall assessment at the first visit. A CBCT scan provides 3D cross-sections and is needed for measurements such as bone width and density and the distance to nerves and sinuses.
Is a CBCT scan needed before every implant?
A CBCT scan is taken when the dentist considers it necessary. As bone width, density and nerve and sinus distances cannot be assessed on a panoramic X-ray, CBCT offers important advantages in implant planning.
How much radiation does a dental CBCT scan involve?
Dental CBCT uses a much lower dose than conventional medical CT. A lead apron is worn during the scan, and imaging is carried out only when it is clinically necessary.
What is guided implant surgery?
A patient-specific template, made from a virtual plan on the CBCT scan, helps place the implants in their pre-planned positions. In suitable cases, it can be performed without opening the gum or placing stitches.
The information on this website is for general information only and does not replace an examination, diagnosis or treatment plan by a dentist. Treatment and outcomes vary from person to person.