Hakam Rabi1, Emad Qirresh2 and Tarek Rabi2*
1M.Sc. Lecturer, Al-Quds University, Palestine, Jerusalem
2Assistant Professor, Al Quds University Palestine, Jerusalem
Received: 14 November, 2016; Accepted: 27 February, 2017; Published: 01 March, 2017
Tarek Rabi, M.Sc., Lecturer, Al-Quds University, Palestine, Jerusalem, E-mail:
Rabi H, Rabi T, Qirresh E (2017) Radiographic Prescription Trends among Palestinian Dentists for Dental Implant Placement – A Cross Sectional Survey. J Dent Probl Solut 4(1): 011-014.10.17352/2394-8418.000040
© 2017 Rabi H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
IOPAR: Intra Oral Periapical Radiograph; OPG: Orthopantomography; CT: Computed Tomography; CBCT: Cone Beam Computed Tomography; AAOMR: American Academy of Oral and Maxillofacial Radiology; EADMFR: European Academy of Dentomaxillofacial Radiology; EAO: European Association for Osseo Integration; ICOI: International Congress of Oral Implantologits; ALARA: As Low As Reasonably Achievable.
Background: In this present era implant dentistry has seen exponential growth and its success mainly depends upon a proper treatment planning and its execution. Radiographic imaging has a pivotal role in the planning of implant placement and follow up of implant survival.
The Context and Purpose of the Study: To study the radiographic prescription trends for dental implants among Palestinian dental practitioners. A sample of 150 dentists chosen at random in a dental conference received a questionnaire.
Results: 114 dentists returned full questionnaires. It was observed that the majority of the surveyed dentists prescribe panoramic radiographs for dental implant assessment based on its availability. The motivating factors for prescribing the specific radiologic examination was Availability (42.99%), availability + cost(17.53%), Cost + Measurement precision(3.51%), Cost + Radiation Dose(10.53%), Measurement precision(25.44%).
Conclusion: The majority of surveyed dentists prescribe panoramic radiographs for dental implant assessment based on its availability and only a small number strictly adhered to the recommended guidelines of the international associations with regards to cross sectional imaging.
Dental Implants are being widely used for the replacement of missing teeth. Dental practitioners have remarkably taken up this treatment modality and adapted to the advancements in oral rehabilitation. The main criterion in assessing the success of oral implants has been the marginal bone loss evidenced by the radiological examination [1-3]. The imaging objectives aids the clinician in providing the cross-sectional views of the dental arch for visualization of spatial relationship of anatomic structures of the maxilla and mandible, the quality and quantity of available bone, the presence of infra-bony lesions, the occlusal pattern and the number and size of implants as well as prosthesis design, all which are essential for successful implant treatment planning and evaluation of the ongoing implant functioning . Many types of radiographic modalities are used in implantology namely Intra-Oral Periapical Radiography (IOPAR), Orthopantomography (OPG), occlusal radiography, Conventional tomography, Computed Tomography (CT) and Cone-Beam Computed Tomography (CBCT). Usually, it is up to the practicing clinician to decide which modality best suits their needs [5-7]. The recent position paper on the use of radiology in dental implantology put forward by the AAOMR recommended that cross-sectional imaging be used for the assessment of all dental implant sites and that currently CBCT is the imaging method of choice, at present, to gain this diagnostic information . There is an extreme scarcity worldwide regarding the literature stating the radiographic prescription trends among the implant practitioners worldwide and whether they adhere to the recommendations put forward by professional bodies like AAOMR, EADMFR, EAO and ICOI . Hence looking at the need of the hour, an attempt was made to survey the radiographic prescription trends among the dental practitioners.
Materials and Methods
150 close ended questionnaires were distributed to the dentists who participated in a dental conference in Ramallah Palestine, in 2015. Out of 150 participants, 114 dentists (65 males, 49 Female) completed the survey. The questionnaire was formatted in a way to enquire about their radiographic prescription methods for pre and post-operative assessment in their implantology practice and data collected regarding the radiographic prescription practices for pre- operative implant assessment and follow up, such as Panaromic Radiograph (OPG), Intra oral Periapical radiograph (IOPAR) and Computed Tomography (CT). The study received ethical approval under the file 9/REC/18. They were also asked whether combination modalities were used in the assessment. The questionnaire also enquired on motivating factors for choosing the radiographic examination, whether they have problems with over or underestimated measurement in panoramic X ray and its frequency, usage of CT for implant imaging and its frequency and the usage of Periapical radiographs. The data collected from the survey were analyzed using Graph Pad Prism software and the results were determined.
The survey was carried out on 114 dentists having clinical experience of more than 10 years (16.67 %), 6-10 years (79.82 %) and 1-5 years (3.51 %). The Gender distribution of radiographic examinations more often prescribed for dental implant assessment were shown in Figure 1. Approximately 59% of dentists prescribe panoramic x-ray whereas 41% of the dentists prescribe a combination of Panoramic X ray + CT imaging.