Periapical radiography (PAR) is the most commonly used radiographic technique in dentistry. It is available in virtually all clinics, involves the lowest radiation dose, and provides the highest spatial resolution among all imaging methods. It is inexpensive, straightforward to perform, requires only a few minutes, and can be visualized immediately.
SXR is simple to set up and use. It can be performed with minimal patient cooperation. It is also safe, as it reduces the risk of swallowing or aspirating the depth gauge—an especially valuable feature for sedated patients.
The depth gauge itself acts as a ruler, allowing assessment of distortion and radiograph calibration, thereby enabling high-precision measurements.
One of its main benefits is that it provides immediate, real-time feedback, allowing the surgeon to adjust the surgical approach on the spot, thus increasing both precision and safety. The image is obtained within minutes, making it possible to verify whether the osteotomy has been performed correctly or to detect errors before they become irreversible.
Additionally, the technique is repeatable, allowing periapical radiographs to be obtained at various stages of the drilling sequence whenever additional information is required to clarify uncertainties during the surgical procedure.
The preoperative protocol must be tailored to each case. In many straightforward cases, this technique can eliminate the need for more complex studies involving higher radiation exposure. CBCT should be used only when the required information cannot be obtained through conventional lower-dose dental radiography, in accordance with the ALADA principle (As Low As Diagnostically Acceptable). Radiation exposure associated with 3D scans should always be considered, particularly in cases where no clear diagnostic advantage is present. CBCT imaging should therefore be justified only when the additional information directly influences treatment decisions.
Intraoperative PAR can also be useful from a legal standpoint, serving as evidence that all available means were employed to prevent complications.