A molar was pulled 2 years ago. bone material would not hold in socket since a wall(s) broke. is a 3d cbct needed to see is sinus augmentation needed?

On site: That's an on site decision your Dentist, Prosthodontist, Periodontist, or Oral Surgeon will have to make after doing a physical examination and reviewing your existing x-rays. Don't ask the Dentist or Specialist to work "blind" if they feel CBCT required to properly diagnose your treatment needs.

Yes: It is best for your surgeon to see what you need regenerated before begining treatment. Also, the loss of a wall does necessarily preclude successful socket grafting.

It would help: Axial act with 3D reconstruction is extremely useful in these instances. This will help locate dental nerve and help plan treatment. Any possible infection may be seen and treatment also planned. Plus an added advantage is it is painless. And quick. Hope that helps . Best wishes

Possibly: You didn't say what the plan is for the edentulous space. Are you planning on having an implant placed? In any case, you should have it evaluated by a specialist. Make an appt to see a periodontist or an oral surgeon.

Maybe: If your surgeon has a CBCT machine in the office, (s)he'll use it for sure. Those machines are very expensive! In my humble opinion, the technology is great, and the surgeon can learn lots from a 3-D image. As to whether is it necessary to have all that information, that depends on the particular situation. Some situations are very simple, others more complex. Ask your surgeon to explain.

Yes for best diagnos: A CBCT will give the best view of the bony architecture of the area that will allow the surgeon to do the best job in this area. Without that view it's hard to estimate tha the perimeter and thickness and suitability of the bone in the affected area

It's VERY Helpful: Sounds like you lost a lot of bone when that molar was removed. Sorry the bone graft didn't work as planned. Now, if you want a dental implant there, it's going to be compromised...not quality, but possibly insufficient amount/volume of bone. Luckily, if you need more bone, you can augment the sinus easily nowadays. CBCT would be the ideal way to figure that out. Without it, you're just guessing.

Yes: X-rays can be used to evaluate the need for sinus lifts Most digital X-ray softwares have measuring tools but they are not so accurate. To properly diagnose and treatment plan a sinus lift a cbct/ ct scan Is required.

Consult with Surgeon: Since you have already had complications in the attempt to build up the bone prior to implant placement, your surgeon may feel it necessary to have a Cone Beam Computed Tomograph (CBCT) taken in order to evaluate the area and avoid complications in any future procedures.

Needed for Treatment: It may be possible to determine the need for sinus augmentation based only on a panoramic x-ray, rather than a cone beam type x-ray. However, most dental surgeons would require the cone beam before treatment is done. Personally, I would not perform a sinus augmentation without the information provided by a cone beam x-ray.

Yes for best results: If a bone wall broke and a sinus relatively close to the dimension of existing bone with a minimal amount of bone, a CBCT would be indicated.. If you have a normal radiograph of the area after the tooth was removed and want to send it to sdsaz@roadrunner.com I can take a look at it. Scott Sazma DDS POractice Limited to Periodontics.

In Short, Yes: A CBCT gives a complete view of what is going on and why they material failed. Other X--rays are 2D pictures of 3D objects and do not give full detail. In most cases the question is not IF sinus augmentation is needed but WHERE augmentation is needed and the only way to know that is the 3D image.

CBCT helps: For upper molars, the height of the bone is limited due to the sinus. Sometimes a regular film is sufficient to see if sinus bone graft is needed. 3D CBCT allows for more precise view of the bone contour and where the bone is deficient so amount of graft can planned. It can also help to check if any bony projections or irregular contours are present so surgery can be more precisely planned.

CT Scan needed IMHO: Regardless of the situation, my office takes a CBCT (3D xray) for every implant placement to avoid hitting vital anatomical structures (blood vessels, nerves, sinus wall). In your case, I would agree with the practitioner who is placing the implant. The floor of the sinus can be irregular and perforation can lead to infection or other sinus/nasal complications. I hope this helps, Harbinder.

Best: At By Design Dental Implant Center we take a CBCT scan of every patient considering dental implant treatment. The amount of data obtained is incredible and helps tremendously in assessing the areas for potential implant placement. Also, we are able to see the bony contours under the tissues and frequently detect underlying areas of infection which often go unnoticed without this technology.