Panoramic radiography for routine dental implant planning in the posterior mandible

Dental implants are a widely used treatment option to replace missing teeth. Along with the growing popularity of dental implants, 2 and 3-dimensional imaging modalities have become commonplace. In the posterior mandible, visualization of the mandibular canal is essential to select the correct implant length, thereby limiting the risk of inferior alveolar nerve injury that can lead to irreversible sensory disturbance of the lower lip and chin. Unfortunately, no preoperative imaging modality gives a “perfect” visualization of the mandibular canal. Non-essential radiation exposure should be avoided and unconsidered systematic preimplant 3-dimensional imaging is to be discouraged. For routine posterior mandibular implant planning, a thorough clinical examination of the mandibular morphology and a panoramic radiograph are recommended. When a safety margin of at least 2 mm is respected, panoramic radiography is sufficiently accurate to evaluate the available bone height above the mandibular canal