Cone-Beam Computed Tomography for Oral and Maxillofacial Imaging

Abstract

The invention of computed tomography (CT) technique revolutionized diagnostic imaging. Compared to conventional X-ray imaging procedures, CT involves higher radiation doses. Recently, cone-beam CT (CBCT) specifically designed for maxillofacial imaging was introduced. CBCT technique is based on a cone-shaped X-ray beam centered on a twodimensional (2D) detector. The detector system performs one rotation around the patient, producing a series of 2D images which are then reconstructed in a 3D data set. The contemporary knowledge regarding CBCT and its proper application guides the practitioner for improvement in diagnostic purposes and treatment planning. The aim of this chapter is to focus on the details, advantages, drawbacks, and clinical applications of CBCT as a headmost CT imaging technique in the oral and maxillofacial (OMF) region. The main clinical applications of CBCT in the OMF region are dentistry including dentoalveolar and maxillofacial surgery, orthodontics, endodontics, and periodontics; and otolaryngology. The aforementioned clinical use of CBCT was described in detail with illustrated sample cases. In most of the cases in OMF region, CBCT takes the place of multi-slice CT. Thus, clinicians should know the clinical applications and capabilities of CBCT technique with its drawbacks.

Application of CBCT in oral & maxillofacial surgery

“…2.1. Advantages of CBCT over conventional CT scan [6][7][8] 1. CBCT is a compact system, providing in-office imaging and also is cost effective.…”

“…Has exclusive display mode for maxillofacial imaging. 8 1. Scattered radiation with restricted dynamic range of the X-ray detectors.…”

“…CBCT can also be used for detection of the fractures as a reliable substitute to CT scan. 8 The specific software aided CBCT technology can also be used for preoperative virtual planning required for manufacture of customized reconstruction plate for mandibular fractures. 22 During the comparison of CBCT with multi-detector CT in diagnostic imaging of midface, CBCT provided better image quality at comparatively lower doses, comparable image quality at higher doses, and superior spatial resolution in standard-and reduced-dose settings.…”

Gambaran peri-implantitis pada CBCT (Cone-Beam Computed Tomography)

“…Radiograf CBCT kasus peri-implantitis yang menunjukkan resorpsi tulang di sekitar implan gigi. 56 Gambar 9. Radiograf CBCT yang menggambarkan 2 implan di sisi kanan mandibula yang telah menembus dan melewati saluran saraf.…”

“…Kriteria yang menentukan keberhasilan implan gigi terus berubah, termasuk diantaranya adalah tidak adanya mobilitas pada awal fase prostetik, tidak adanya radiolusen berkelanjutan di sekitar implan, tidak adanya peri-implantitis dengan supurasi, dan keluhan subjektif dari pasien. 53 Keberhasilan implan gigi dilakukan dengan cara mengevaluasi secara rutin, dibutuhkan bantuan radiograf foto untuk melihat beberapa keadaan seperti adanya osseointegrasi implan gigi dengan tulang (Gambar 8) 54 , apakah implan gigi telah menembus dan melewati saluran saraf (Gambar 9) 55 , atau untuk melihat kasus peri-implantitis yang menunjukkan resorpsi tulang di sekitar implan gigi (Gambar 10) 56 , sehingga didapatkan gambaran yang jelas tentang keberhasilan atau kegagalan dari implan gigi yang dipasangkan.…”