AAOMR position paper lacks foundation, harmful to dental profession.

" If all you have is a hammer, everything looks like a nail. " This familiar expression refers to our common tendency to see the world through our own biased viewpoint. And so it also apparently goes for the American Association of Oral and Maxillofacial Radiology (AAOMR). We could not help but react with surprise and disappointment upon reading the editorial appearing in the June, 2012 edition of the Journal of Oral Surgery, Oral Medicine, Oral Pathology entitled, " Position statement of the American Academy of Oral and Max-illofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. " 1 Among a number of questionable statements and opinions found throughout the document, one prophetic proclamation stands out as an obvious misconception to those who practice clinical dentistry on a daily basis. Found in the abstract portion of the paper, the AAOMR recommends that " …cross-sectional imaging be used for the assessment of all dental implant sites and that CBCT is the imaging method of choice for gaining this information. " However, the authors have apparently failed to take into account a number of important facts in reaching such a conclusion. Paramount among these would be the absence of controlled studies or data to support the advisory opinion. Despite the lack of evidence based science demonstrating improved patient outcomes with 3-D CBCT, nor documented harm to patients if not utilized, the statement is nevertheless made for the world to accept and to live by as if it were proven and authenticated doctrine. The authors also fail to account for the fact that the overwhelming majority of dental surgical procedures performed on a daily basis, including removal or exposure of impacted teeth, sinus lifts, bone grafts, and yes, also dental implants – especially in the hands of those with adequate training and experience – are performed successfully, and without the need for 3-D imaging. A typical implant site with an obvious lack of bone on the facial aspect, as one example, does not require 3-D imaging to impart the knowledge that a bone graft is required on the facial aspect. Simple inspection and palpation, as well as direct visualization during surgery is more than adequate to acquire this information. Conversely, a site with obvious sufficient ridge width, height of bone above the inferior alveolar nerve, or beneath the sinus floor, does not …