Purpose: To compare the bone height of implant sites measured using panoramic radiography and spiral CT. Materials and Methods : The available bone height was determined for 263 maxillary and mandibular implant sites in 59 patients. Distortion was calculated using the metal bar for the panoramic radiographs. Results: Significant differences in mean bone height between the two imaging modalities were found in maxillary and mandibular anterior regions (p<0.05). The mean difference in bone height recorded by the two techniques was smallest in the maxillary and mandibular molar areas (0.8 mm), and greatest in the mandibular anterior region (1.3 mm). With the exception of the mandibular anterior region, ninety percent of all the sites showed measurement differences within 2 mm. Conclusion: A safety margin of 2 to 3 mm is called for when utilizing panoramic radiography, otherwise additional imaging modality such as computed tomography is necessary to obtain accurate measurements.