Presentation Summary Dental Implants Evaluation for restoration: CBCT shows where an implant has been placed (in the bone and tissue) if a patient comes to your office seeking implant restoration. Prevent damage to permanent vital structures (and avoid high-award lawsuits). Fabricate surgical guides for implants for exact placement with pre-determined angles and depth control. Surgical guides and models can be printed in office with a 3-D printer. Many patients worry about the radiation doses from CBCT compared with those of diagnostic X-rays. Dr. Parashar allayed these fears by explaining that the standard dose of radiation with a CBCT is 65 microsieverts (mSv). A digital panorex X-ray is 21.5 mSv, a digital cephalometric X-ray is 4.5 mSv, and a full mouth series of bitewings and PAs is 40 mSv. If a patient undergoes a full mouth series (40) and a pano (21.5), they have had more radiation than one CBCT. Summer 2017 PCSO Bulletin To ensure accurate diagnosis, clinicians must ensure there are no artifacts or operator errors on the images. This can include patient movement, machine calibration, and ring artifacts. Assistants or radiology techs must ensure that the patient is secured before starting the capture. CBCT machines should be calibrated daily in a busy office, usually in the morning before patients arrive. Slower offices can calibrate their CBCT machines every other day, and at minimum two times a week. Ring artifacts are a calibration issue; they may be superimposed on areas that need to be read by the radiologist. This problem can be avoided by calibrating the machine. Dr. Parashar noted that some CBCT machines have QIQ filters; users should be careful when using this filter. If the filter is checked and active, it sharpens the image and can make it unclear. This can be dangerous because the result could resemble osteosarcoma when in fact it is an artifact of the filter. Dr. Parashar can be reached at drvj77@yahoo.com with questions or comments. 57