A questionnaire study to investigate custom and practice of imaging methods for the anterior region of the mandible prior to dental implant placement.

OBJECTIVES: To investigate the custom and practice of private dental implant practitioners in the north-west of England when planning imaging methods prior to implant placement in the symphyseal region of the edentulous mandible. To gain an understanding of decision-making when prescribing imaging methods.
METHODS: A web-based questionnaire presented two realistic clinical scenarios. Both were of edentulous patients for whom implant-retained lower complete dentures were planned. A mixed mode survey methodology was employed.
RESULTS: 169 dentists were surveyed with an 80% response rate. The results showed no agreement on prescription of imaging methods. Those in the 0-10 years qualified group were significantly associated with the prescription of three-dimensional (3D) imaging. Implant practitioners who place more than 100 implants per year were significantly associated with the non-use of imaging guides and prescription of the same view for both cases. The sample as a whole, however, changed their prescription according to the case difficulty. Those who have a cone beam CT machine available were more likely to use 3D imaging regardless of the difficulty of the case.
CONCLUSIONS: Existing guidelines are open to interpretation and could be construed to support a range of imaging choices. Training in dental implantology may leave dentists to make their own judgements about selection criteria. The idiosyncratic nature of independent dental practice may be an important factor in the chaotic pattern of prescriptions. There is a need for widely disseminated, evidence-based selection criteria for imaging prior to dental implantology which are clear and specific.