Panoramic Scan Versus Cone Beam Scan

What Is The Standard of Care For X-Rays For Impacted Wisdom Teeth?

Picture X-ray Human Skull

The standard of care based on the most recent white papers by the ADA and AAOMS for pre-treatment x-rays for third molar teeth (“wisdom teeth”) is the panoramic scan. The truth is that technology continues to march forward and the Cone Beam Scan gives a far better view of the related anatomy in three dimensions. With this scan we are able to manipulate the images to see those relationships in great detail.

Cone Beam Scan Gives Greater Details

The cone beam scan (CBCT) images are helpful in most all cases as they give so much more detail and much greater detail. If it is affordable to you I would recommend the CBCT for all cases. Having said that, I feel that most third molar treatments can be provided safely with just the panoramic view. That is the only imaging that we had for the first twenty years of my practice life and we had an excellent technique – result quotient. We rarely have complications. We have always been careful and gentle no matter. It is when there are specific findings clinically that we may be directed toward additional imaging. It is when the panoramic scan points us toward those clinical risks that I specifically urge patients to let us take the cone beam scan.

The relationship of the lower wisdom teeth to the nerve bundle in the jaw is the most common “risk reason” for me to advise a cone beam scan. The inferior alveolar nerve (IAN) is a branch of the mandibular division of the trigeminal nerve. The trigeminal nerve carries sensory information such as touch, pressure, temperature, and pain from the facial structures to the brain. The IAN does not control any muscles, but it affects both feeling and proprioception (awareness of the structure in space) to the lip, chin, teeth, and gums in the lower jaw. Injury to the nerve can result in diminished or loss of feeling in part or all of these areas. Having the cone beam scan does not eliminate the risk, but it can reduce it significantly by giving us more specific information about the nerve location. Basically, it tells me which areas to avoid in the surgical procedure. To the date of the writing, I have had no problems with injury to the nerve in all third molar cases where we have had the cone beam scan.

Powerful and Helpful Imaging Tool

Again, I would recommend considering the scan for anyone having a procedure done on their jaws, but more specific indicators would include; wisdom teeth, lesions (growths, cysts, tumors), tooth position abnormalities, orthodontic concerns, TMJ problems, dental implant planning, and evaluation of growth abnormalities, to name a few. Once you see a cone beam scan and experience the visual manipulation of the images you quickly realize what a powerful and helpful imaging tool that it is. You also realize how much value it can have toward your proper diagnosis and treatment.  

Learn more about cone beam scans for wisdom teeth treatment at Dr. Wagner Oral Surgery & Dental Implant Specialists. Give us a call at (262) 634-4646 today in Milwaukee.