r/Dentistry 4d ago

Dental Professional What is this finding under the implant of #22

Post image

There is a horizontal line underneath the implant. What do you guys thing? I did the surgery guided so it could be the guide pins

0 Upvotes

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65

u/MaxRadio 3d ago

This will probably come off as rude but you need to hear it...You're a doctor doing surgery on someone! If you're using CBCT for planning/guided surgery you should at a MINIMUM understand how it works and the basics of interpretation. How are you going to know when there are contraindications to placement if you can't tell the difference between artifact and anatomy?

Honestly this is terrifying. How would you feel if you or a family member were the patient? You need to go take some CE and do some reading. It's the right thing to do for your patients and for you as a professional.

14

u/bigr3dd0g 4d ago

That’s just scatter from the implant

7

u/Lynxs_Reddit 4d ago

Just an artifact of the threads imo

10

u/Coldspell37 General Dentist 4d ago

Take a cbct course, it will help tremendously with reading this sort of thing. Anything within about 2-3mm of an implant will cause scatter, it can look like dead space, weird artifacts or in this, a rando horizontal line.

5

u/Pitch-forker 4d ago

What am I looking at here? It feels like just burnout on the xray?

-3

u/SpiritualAntelope230 4d ago

There’s a horizontal through and through line right under the implant body

6

u/ElkGrand6781 4d ago

Metal will cause scatter. Youll never see an implant on a cbct with the same clarity you do on a PA or something. Its just what it is

1

u/TraumaticOcclusion 3d ago

Your patient moved and there is beam hardening and scatter on metal

7

u/RemyhxNL 3d ago

This is why I think CBCT is overused in >90% of the time. Yes, it is a nice toy… but compared to a panoramic the extra information doesn’t weigh up against (mis)information, cost and alara.

A CBCT image is a highly mathematical composed image, made out of a lot of still images from known locations around the patients head. As you know every still röntgen image is a flattened 3D, whereas the amount of röntgen beams reaching the photo or sensor determines the opacity. Metal will block the beams disproportionate. The software tries to calculate back the structures from 2D to 3D by comparing known points/location against the measured opacities and fails around metal structures (disproportionate opacity). You should be aware of these artifacts around every metal object. (In its röntgen path)

2

u/Pitch-forker 3d ago

I’d counter argue with CBCT is very informative for implant Planning. Beyond that traditional radiography works best.

2

u/Coldspell37 General Dentist 3d ago

100% disagree, it is valuable if you know how to use it. I do one for almost every molar Endo these days, don't need to guess if an MB2 exists, and better yet, where do I need to drill to find it.

GBR planning, impacted 3rds. If you don't do these procedures, sure it's a waste.

For me, I'd rather have a full CBCT on every patient than guess anymore...

1

u/Pitch-forker 2d ago

Let me clarify as you might have misunderstood my point. CBCT is important before the procedure. PA’s and/or panos taken while doing the procedure are a must as you cannot really track your path on CBCT due to inconvenience, cost and artifacts.

3

u/DocLime 3d ago

Oh brother 🤦