# Radiographic investigation for multiple implant screening is:
A. Intraoral periapical radiograph
B. Panoramic radiograph
C. CBCT
D. Magnetic resonance imaging
The correct answer is B. Panoramic radiograph.
The primary advantage of the panoramic radiograph is that it is a screening tool to evaluate for pathology within the hard tissues. It may also be beneficial to ensure that root tips and other structures are not in the surgical site. As a general rule, sinus pathology is difficult to observe on this film, and other tools are usually necessary (e.g., CT scans).
When the 25% average magnification is accounted for on the film, it may categorize the patient into three different groups:
(1) there is obviously enough vertical bone to place and implant,
(2) there is obviously not enough vertical bone to place an implant, or
(3) the amount of vertical bone necessary to place an implant is not obvious.
Advantages of panoramic radiograph
• Easy identification of opposing landmarks
• Initial assessment of vertical height of bone
• Convenience, ease, and speed in performance in most dental offices
• Evaluation of gross anatomy of the jaws and any related pathologic findings*
Limitations
• Distortions inherent in the panoramic system
• Errors in patient positioning
• Does not demonstrate bone quality
• Misleading measurements because of magnification and no third dimension
• No spatial relationship between structures