David Sarment, DDS delivers a presentation at the 2006 Annual American College of Allergy, Asthma & Immunology Meeting where he discusses a need for closer collaboration of medical subspecialties and demonstrates how a small low dose cone beam computed tomography scanner was the bases of his findings for obstructed sinuses during an evaluation for dental implants.

In-office computed tomography of sinuses for preparation of dental implants
David P. Sarment, DDS, MS; Jonathan Alspaugh, MS;
Rohini Rebello-D’Souza; Webster Stayman, PhD

Cone-beam computed tomography (CBCT) scanner technology has revolutionized dental implant planning performed by periodontists and oral surgeons because, in contrast to costly helical scanners, CBCT scanners acquire head and neck regions with fine precision, high contrast and low radiation.

Consequently, surgeons encounter more undiagnosed sinus pathologies that are likely related to allergic reactions. Therefore, this pilot study was aimed at evaluating cases for potential sinus obstructions and raise awareness of a common need for referrals for medical evaluation prior to oral surgery.

Twenty consecutive patients with no self-reported history of chronic sinus allergy and referral for CBCT scanning in preparation for oral implantation participated. After review of the IRB consent form, patients received routine scanning. One clinician retrospectively examined all the scanning data visually and found that 60% of cases had at least one sinus with detectable thickening of soft-tissues. Of these cases, 40% demonstrated bilateral partial obliteration. One sinus was more than 50% obstructed, and one other sinus was more than 90% obstructed. These two cases were referred for medical evaluation prior to dental treatment.

Osseous grafting of the sinus floor in preparation to dental implant placement is a common procedure. Small CBCT machines allow for rapid in-office scanning, reducing costs, radiation dose, and patient apprehension of the procedure. Because of scanning availability, increasing referrals from dentists to physicians is expected. The present initial report demonstrates that positive non-symptomatic sinus diagnosis is significant, suggesting a need for improved inter-disciplinary collaboration.

Abstract for submission to 2006 ACAAI Annual Meeting, Philadelphia, PA

In-office computed tomography of sinuses for preparation of dental implants

Dr. David Sarment, DDS, MS
Diplomate, American Board of Periodontology
Department of Periodontics/Prevention/Geriatrics
University of Michigan School of Dentistry
1011 North University Ave.
Ann Arbor, MI 48109-1078
Tel. 734 615 4023; Fax. 734 763 5503
sarment@umich.edu