Dentistry/CT scan


Dr. Kaufman, in 1998 i had a jaw CT scan for a small block graft in the upper anterior. Implants replaced #7,10. 8,9 Missing. Restored with a 4-unit bridge. Since then lost some bone/gum due to lower incisors torquing the upper bridge. The implants are not mobile, seem stable. I'm worried if/when i need to address the bone loss i'll have to get another CT scan and more grafting. Now i need to get a CT scan of sinuses without contrast. Is it possible or a good idea to combine dental and sinus CT in one to avoid more radiation exposure in the future by expanding the area of interest from sinuses to the upper jaw?

Dear Robert:
I'm sorry to hear that you are having difficulties with your implants.  However, you should NOT be worried about the CT at all.  The Radiation level of today's CT scanners are incredibly low, especially when you compare to the levels given in 1998.  The CBCT units that most oral surgeons and many other dental specialist and general dentists have are fantastic and give excellent diagnostic information with less radiation than many old, conventional intra-oral X-ray units.
Unless you were exposed to major doses of radiation, such as a nuclear disaster, or radiation therapy for cancer, you are not at any risk and another CT for the benefit of knowing what is going on with your sinuses and implants outweighs any possible drawbacks.
I do not know who ordered your sinus scan, and I do not know what it is that that other doctor is looking for.  Theoretically, one might be able to get information for both areas in one scan.  However, you need to speak to the doctor who ordered the sinus CT.  He might be looking for something different that the dental scan allows.
The more important part of the story is actually the condition of the implants.  In 1998, the parameters of implant placement were different than today, and many advances and studies have been made since.  The location of the implants today is recommended to be at a different position than we did in 1998.  I have placed implants then and today, and I can tell you that I would do thing much different today, including the type and design of the implants that I would use.  The bone and tissue loss that you have is actually common enough, and it is usually due to the actual position of the implants and how much bone you have to the facial (outside surface) of them.
It is probably NOT due to the lower teeth.  This is a common misconception.
You should consult with a Periodontist, an Oral surgeon, or a Prosthodontist and see what is the most appropriate course of action in your case.  You MUST address the issues with the implants, even if by addressing the issue it means to just observe them every six months and recording the status of the tissues with X-rays and Photos.  I have had similar experiences with my own patients over the years.  Some were addressed with surgical procedures, others were just watched over time and are still doing well.  Each patient is situation specific and has to be addressed individually.
Please speak to the specialists involved and follow their advice.  Do not worry about the scan.  The benefits of the information outweigh any concerns, by far.
Best of luck,


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Zev Kaufman, D.D.S.


I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.


Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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