Imaging Technique Selection for the Preoperative Planning of Oral Implants: A Review of the Literature zyx Charbel BouSerhal, DDS, MScD, PhD;*t Reinhilde Jacobs, DDS, PhD;*$ Marc Quirynen, DDS, PhD;" Daniel van Steenberghe, MD, PhD, HFRCS( JRC), Drhc* ABSTRACT zyxwvutsrqpo Background: As the use of oral implants for the treatment of partially as well as fully edentulous patients has increased the past two decades, more specialized radiographic techniques have become available for the preoperative planning of oral implant placement. Purpose: The goal of this article was to enable clinicians to select the appropriate imaging techniques when planning for oral implants. Materials and Methods: This article reviews the available literature about various imaging techniques and their indication for the preoperative planning of oral implants. The advantages and drawbacks of each technique are described. A dosimet- ric overview is given relative to different radiologic techniques used in various clinical situations. Results: For preoperative planning of implant placement, advantages and drawbacks of the available imaging techniques have been considered, which allows guidelines for image technique selection to be formulated based on the clinical situa- tion provided, considering the diagnostic yield of each technique and the radiation doses involved. Conclusions: From the available literature, it can be stated that many clinical situations demand the use of cross-sec- tional imaging techniques for optimal preoperative planning of implant placement. Nevertheless, such techniques are not required in cases in which the clinical examination reveals sufficient bone width and where standard radiographic exami- nations, such as intraoral and panoramic radiography, reveal adequate bone height and space for implant placement. zy KEY zyxwvutsrqpon WORDS: computed tomography, jaw bone, oral implant, osseointegration, radiation doses, spiral tomography urrently, oral implant placement is routinely used C as a treatment modality in the rehabilitation of the edentulous jaw bone.'-3 The increasing demand for implant treatment has also raised interest in the avail- *Department of Periodontology, School of Dentistry, Oral Pathol- ogy and Maxillofacial Surgery, Katholieke Universiteit Leuven, Leu- ven, Belgium; +Department of Periodontology, School of Dentistry, Universitt! Saint-Joseph, Beirut, Lebanon; 'Oral Imaging Center, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Katholieke Universiteit Leuven, Leuven, Belgium. R. Jacobs is a postdoctoral researcher of the Fund for Scientific Research, Flan- ders, Belgium. D. van Steenberghe is Holder of the P-I Brinemark Chair in Osseointegration. Reprint requests: Reinhilde Jacobs, DDS, PhD, Oral Imaging Center, Department of Periodontology, Faculty of Medicine, Katholieke Universiteit Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium; e- mail: zyxwvutsrqp reinhiIde.jacobs@med.kuleuven.ac.be 02002 BC Decker Inc able imaging techniques to perform a proper yreopera- tive planning prior to oral implant placement. Until the mid- 198Os, plain zyx film radiography was used for preoperative assessment of potegtial implant sites in the edentulous jaw bone. Later, more advanced imaging techniques were introduced (eg, computed tomography [CT]) to improve this planning and to consider factors such as buccolingual dimensions and precise anatomic relations with structures in the maxillofacial region. However, selection criteria for these preoperative plan- nings were not available and guidelines were not fol- lowed, generally resulting in overconsumption of advanced imaging techniques. Hence, there was an obvi- ous need to evaluate the reliability and accuracy of these cross-sectional techniques for two main reasons: primar- ily, because of its important effect on treatment outcome and, secondly, because of the radiation doses involved. 156