Thank you for the opportunity to comment on Dr Larsen's interesting observations. Although his comments are understood and respected, they appear to originate from a misunderstanding of our report and have led to inaccurate conclusions. Dr Larsen opines that it is not appropriate to describe “who” in practice parameters. This represents his personal preference and not a universally accepted policy. In fact, we have found that although some organizations do not address this subject, others do describe qualifications and responsibilities of personnel (eg, the American College of Radiology), as well as criteria for referral to others (eg, the American Dental Association). Dr Larsen states that the Parameters report has “indicated that the majority of diagnostic procedures are preferably performed by an oral and maxillofacial radiologist.” This is incorrect. Nowhere in the document do we assert or even suggest such a position. To the contrary, the American Academy of Oral and Maxillofacial Radiology believes that dentists should function as their own radiologists in the diagnosis of most dental diseases. However, there are instances—usually involving interpretation of images made with specialized modalities—in which the best interests of the patient are served by involving individuals with relevant training and experience. It is in these relatively few circumstances that we recommend the involvement of specialists. Indeed, in no instance in the Parameters report do we indicate that the active participation of an oral and maxillofacial radiologist is required. Rather, we contend that oral and maxillofacial radiologists do have the requisite training and can assist other dentists with their cases. Dr Larsen disagrees with the Academy's perspective that imaging of potential implant sites should be augmented with cross-sectional imaging techniques. We are unaware of any cost-benefit analyses that support his view. Our position is one of caution and is derived from adverse effects described in the literature, 1 Tepper G Hofschneider UB Gahleitner A Ulm C Computed tomographic diagnosis and localization of bone canals in the mandibular interforaminal region for prevention of bleeding complications during implant surgery. Int J Oral Maxillofac Implants. 2001; 16: 68-72 PubMed Google Scholar , 2 Givol N Chaushu G Halamish-Shani T Taicher S Emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region. J Periodontol. 2000; 71: 1893-1895 Crossref PubMed Scopus (96) Google Scholar , 3 Mordenfeld A Andersson L Bergstrom B Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. Int J Oral Maxillofac Implants. 1997; 12: 558-561 PubMed Google Scholar as well as from our individual experiences as members of implant teams. Dr Larsen concludes with an appeal that those of us in Oral and Maxillofacial Radiology be involved in research that can “improve patient outcomes.” We could not agree more and are proud to point to our rich body of literature extending practically to the discovery of x-rays in 1895. Indeed, this very Journal has been publishing such research in our field for more than half a century. Perhaps a risk-benefit analysis of cross-sectional imaging for implant placement would be a useful topic for a collaborative study among various specialties. Finally, Dr Larsen comments on the publication policies of the Journal. Although the Editor might best address this question, it has been the practice of the Journal to publish material from sponsoring academies and organizations for many years. It is appropriate and expected that specialty groups provide their expertise to improve patient care. The American Dental Association has recognized the specialty of Oral and Maxillofacial Radiology for their ability to do such. To do otherwise would be shirking our responsibility to both the profession and the public. We note that recognition of a new specialty in any profession often engenders concern or even anxiety among related disciplines. We hope that with the recognition by the American Dental Association of Oral and Maxillofacial Radiology as a specialty of dentistry, our colleagues will see us as allies serving the common interests of helping our patients and advancing our profession.