Dental Implant Planning (CBCT)
Cone-beam CT of the maxilla or mandible for implant planning — assessment of alveolar bone volume, proximity to inferior alveolar nerve and maxillary sinus, identification of pathology. Lower dose than medical CT and available in-office at most implant-focused practices. Data exported as DICOM for planning software (coDiagnostiX, SimPlant, Blue Sky Plan, NobelClinician) and surgical guide fabrication.
Clinical pathway
- Small- or medium-FOV CBCT — typically 5×5 to 10×10 cm covering implant site + adjacent structures.
- DICOM export + merge with intraoral scan or digitized impression.
- Virtual implant placement — length, diameter, angulation relative to restoration.
- Surgical guide design + 3D print — bone- or tooth-supported.
- Guided surgery + restoration follow-through.
Typical systems
- Planmeca ProMax 3D family
- Sirona Orthophos SL
- Carestream CS 9600
- Vatech Green family
- iCat FLX
- Planmeca Viso G7
Room + procedure characteristics
- Scan time: seconds.
- Dose: 50–200 µSv typical for single-arch small FOV — much less than medical CT.
- Team: dental assistant acquires, dentist or oral surgeon interprets and plans.
Equipment considerations that bite
- FOV size is the buying decision. Single-implant cases need 5×5 cm; full-arch / TMJ / orthognathic work needs 16+ cm. A unit that locks to small-FOV won't grow with the practice.
- Voxel size and dose mode — sub-200 µm voxels are visible improvements on implant-site cortical-bone read; ultra-low-dose modes for follow-up matter on pediatric / repeat exposure.
- Detector age — flat-panel CBCT detectors degrade similarly to mammo selenium panels. Ghosting and dead-pixel clusters on a 2014 unit are end-of-life signals.
- Software ecosystem — DICOM export quality, planning-software compatibility, and integration with intraoral scanners is the practical workflow. A unit with poor DICOM hygiene breaks the surgical-guide pipeline.
- Tube life — pediatric ortho practices burn tubes faster than expected; small-cohort heavy-use sites should plan refurb tube replacement.
Regulatory + safety posture
- State X-ray-machine registration — dental CBCT is a radiation-producing machine; state registration and routine inspection apply. Annual or biennial physicist survey depending on jurisdiction.
- ALARA in pediatrics — dental CBCT in children is a routine ALARA conversation; small-FOV + dose-reduction modes are not optional.
- Lead-shielded operatory + door interlocks — the install is a building-permit event in most jurisdictions; refurb purchasers underestimate room readiness.
Operational reality
- In-office CBCT pays back on guided surgery volume, not single-tooth implants. A practice doing fewer than ~50 implants / year often finds referral imaging more economical than ownership.
- Software training is the hidden go-live cost. Planning workflows take weeks to internalize; the scanner sits idle while the team learns the planning side.
- Refurb economics — supply is stable, software-version is the price-determining variable, and tube hours track usage rather than calendar age.