Cone-beam computed tomography versus orthopantomography in sinus lift procedures: Two-dimensional versus three-dimensional imaging

Context: The present study was undertaken to do a comparative evaluation of the role of cone-beam computed tomography (CBCT) imaging and orthopantomography (OPG) for preoperative implant planning in combination with sinus grafting procedures to assess sinus anatomy and morphology and the existing bone height in three-dimensions (3D). Aim: The aim of the present study was to assess sinus anatomy and morphology and the existing bone height in all the 3D. Materials and Methods: Pre- and postoperative assessment of maxillary sinuses was done in 17 patients who underwent implant therapy in combination with sinus augmentation procedures using CBCT and OPG. These patients were subjected to orthopantomographs and CBCT imaging both preoperatively and postoperatively. CBCT imaging helped decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication, and comparative analysis between pre- and postprocedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis Used: The results were tabulated and statistically analyzed using paired and unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment types based on pre- and postoperative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of aberrations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely, and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A preoperative planning based on CBCT imaging seems to improve sinus diagnostics and helps execute a better treatment plan. Furthermore, it is a good tool for the comparison of vertical alveolar bone height pre- and postoperatively following sinus augmentation procedures using various graft materials.