The 3D x-ray is fairly new to dentistry. In the past if a cat scan was needed you would have to pay much more and be subjected to much higher x-ray radiation than you do now. In addition, as a dentist, I usually don't need a large area to be imaged. The modern Cone Beam Cat Scan device enables me to take a high resolution image of a relatively small area. This enables me to diagnose problems that traditional x-rays just plain can't image well enough. The result is a much more certain diagnosis resulting better treatment recommendations.
With the Cone Beam Cat Scat, (CBCT) I can better determine how many canals are in a tooth before doing the root canal. Not only are the number of canals better identified, but the path of the canals can usually be seen. This helps greatly as sometimes there is an additional canal that would never be found without the CBCT 3D image. A missed canal results in a much higher chance that the root canal will fail! For implant planning the CBCT is an essential part of my practice. I used to place implants using only the normal panorex and intraoral 2D image. I never have had a problem with the 2D images and all those implants turned out great. I can only thank my lucky stars that I did not have a problem when I used to place implants using only 2D imaging. Since having the CBCT 3D imaging ability I have had many situations where the result may not have turned out as well because I would have used too long an implant. When referring to the 2D image for one of my patients it looked as if I could use an implant that was 2mm longer than the CBCT 3D image showed I could use. I will never place an implant again without first planing the case with a 3D image.
I feel that 3D CBCT imaging is essential to the quality of implants and root canals. Which is why I do not place an implant or do a root canal without taking a CBCT image first. Even the most simple looking root canal can have a surprise in the number and path of the canal(s). I feel strongly enough that I do not charge extra for my implants or root canals when using the CBCT device with those procedures. I do charge a $95 implant consultation fee that does include with that price a free CBCT image and if you are able to get an implant and have me do it, I apply the $95 implant consultation fee to the implant fee.
I have had patients come in with pain and when the standard 2D image was taken, nothing looked amiss. I would then take the 3D image using my CBCT unit and the abscess was clear to see. I had a patient referred to my by one of my other patients, (both are medical doctors). The patient referred had been in pain for a month with severe pain the last few days. This patient's normal dentist did not have a CBCT unit and could not identify the tooth that was causing the pain. The 2D x-rays could not see the abscess. I took the 3D image with my CBCT unit and there was a small abscess superimposed over the sinus. I have had several patients with abscesses that did not show on the 2D x-ray and did on the CBCT 3D image.
The dental cat scan (CBCT) is not the standard of care, rather it is a big step beyond the standard of care. In fact, I believe that the dental cat scan is one of the more important technological advances in dentistry! Part of my training was to tell someone that we would have to wait for the symptoms to present more clearly before knowing for sure which tooth to work on and if a root canal was needed. The reason we have to wait it because when a nerve dies the pain can be referred to different teeth, and even the opposing jaw. The tooth abscess often forms after the nerve dies and in those situations I may still have to tell you we need to wait until the symptoms present more clearly. Fortunately, the abscess is sometimes there at the same time pain is present and when it is an abscess that the 2D x-ray can't see, the CBCT 3D imaging often shows that abscess so I can get you out of pain.
This is our 3D CBCT (Cone Beam Cat Scan)
Abbott Family Dentistry, LLC
1601 Abbott Road, Suite 102, Anchorage, AK 99507 US
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