Radiographic Imaging

Cone-Beam and Radiographic Imaging At Carolina Oral & Facial Surgery, P.A.

There’s a good chance that Dr. Williams will need to obtain one or more x-rays of your jaw, teeth or facial skeleton at some point during your evaluation, or follow up of your condition.  All imaging at our office is digital.  Our practice strongly believes that better planning leads to more predictable treatment results.

I Just Had An X-ray Taken at My General Dentist Office…..

Often, the films (or copies of films) from your referring dentist can be utilized without the need for additional imaging.  However, please be aware sometimes the film images may have inadequate orientation or quality, particularly when an image has been transferred to paper, and critical areas of anatomy cannot always be seen adequately in order to make an informed decision.  In these cases, a new image in our office is typically obtained.  The following are examples, of additional situations when Dr. Williams might recommend additional scans:

  • Anatomy cannot clearly be seen on current x-ray
  • Pathology is present and additional views are required
  • Follow up scans are required for evaluations over a period of time or comparisons
  • Treatment planning requires new x-ray

Poor quality x-ray  Good quality X-ray

What Type of X-ray Will I Need For My Appointment?

Traditional panoramic films are used most often for obtaining screening views of the upper and lower jaw prior to performing wisdom teeth extractions or for evaluation of other problems related to the jaws, including placement of dental implants. Panorex images allow obtaining of a large amount of clinical information for relatively low radiation dosage to the patient. The panorex is a 2 dimensional image while the jaws and facial skeleton are 3-diminsional structures.  Sometimes, a panorex is unable to provide all the clinical information needed by your surgeon.

A common situation is determining the path of the inferior alveolar nerve, and its relationship to the roots of the wisdom teeth.  Sometimes, this cannot be established on a panorex image. Additionally, the alveolar nerve’s relationship to areas of the lower jaw, are critical in treatment planning.  The evaluation of the sinus cavity is often less than ideal with a panorex.  In these cases, a CT scan is often beneficial in helping discern critical anatomy.  The majority of the time this scan is taken in our office.

CT scan showing impacted canines CT scan showing impacted teeth

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Carolina Oral & Facial Surgery Uses their CT Scan To Diagnosis these conditions:

Carolina Oral & Facial Surgery Uses their CT Scan To Treatment Plan these conditions:

Comparisons of Medical Grade CT Scans to Cone Beam 3-D Technology:

There are multiple advantages of Cone-Beam Technology, regarding facial skeletal imaging, when compared with medical grade CT scans:

  • Significantly lower dosages of radiation are delivered to the patient by Cone-Beam CT scans. The dosage of radiation received with certain types of Cone-Beam scans is only slightly higher than that obtained with a panorex film.
  • Convenience…These scans can be obtained while in our office, thereby eliminating additional time off work or appointments.  As the images are generated within several minutes, there is no delay to the patient or surgeon in obtaining the images.
  • Multiple anatomic regions can be assessed 3-dimensionally in one scan-eliminating the need for multiple PA and/or panoramic (or tomographic) images. Both upper and lower jaws are scanned at the time, eliminating the need for additional exposures.

Will Insurance Cover Cone-Beam CT Imaging?

Often, when a patient is sent out for a medical grade CT, with a dental condition, the costs of the CT scan are not covered by the medical insurance company. Occasionally, when the diagnosis is deemed to be medically related, a medical insurance company typically does provide insurance coverage for these scans.

The Cone Beam CT technology is still relatively new in the dental field.  Therefore, not all dental insurance companies have incorporated the ADA codes for these modalities, into plan covered services.  Most of the scans we obtain are for dental purposes, not medical; hence, medical insurance typically will not provide coverage for these scans.  Dental insurance coverage is plan dependent.  We make every effort to obtain insurance benefit information prior to taking a scan.

Patient Safety Considerations

It is the desire of Carolina Oral & Facial Surgery, P.A. to obtain the highest quality needed clinical and radiographic data, in the safest manner and lowest cost to the patient. Having stated this, please understand the following factors:

  • Individual anatomy varies from person to person
  • We want to obtain maximum benefit for the lowest cost to our patients
  • Most patients will benefit from an initial screening panoramic film; in situations where the anatomy suggested from this film is uncomplicated, this may be the only images required.
  • Some patients, however, based upon the information obtained from the panoramic film, will then benefit from an additional cone beam scan in order to discern more detail of areas of concern noted on the panorex- but the costs are additive.
  • Dr. Williams may recommend that some patients proceed directly with a cone-beam scan.  Examples might be: implant patients, patients with complex facial skeletal problems, bone tumors, patients in whom a previous film has suggested close root/nerve anatomy or patients who simply choose to proceed directly to cone beam scan.  Please remember radiation dose with a cone beam scan is just slightly higher than a panoramic film.

Carolina Oral & Facial Surgery, P.A. has made an investment in providing the convenience and safety of digital cone beam imaging directly in our office to you.  When treatment planning dictates or it is important for the continuum of care, the practice shares these images with your physician, general dentist, or restoring dentist.  These images will then be available for them to evaluate in their offices when coordinating treatment plans.