Dental cone beam ct and its justified use in oral health care

Abstract

While dental 2D radiology is still the most frequent diagnostic tool, the inherent nature of jaws and teeth might surely benefit from 3D diagnosis. Nowadays, dental cone beam computed tomography may offer high quality images at low radiation doses and costs. Yet, effective dose ranges of CBCT machines may easily vary from 10-1200 microsievert, being an equivalent of 2 to 240 dental panoramic radiographs. The same holds true for diagnostic image quality, which exhibits a huge variation amongst machines and parameter settings. For segmentation accuracy, lower limits of accuracy are around 200 micrometer, yet again, larger inaccuracies may apply. For linear accuracies, values below 500 micrometer are feasible, with some machines and CBCT parameter settings allowing linear accuracies of up to 200 micrometer. Apart from the radiodiagnostic possibilities, dental cone beam CT may offer a vast therapeutic potential, including possibilities for surgical guidance and further treatment via CAD/CAM solutions for crown and bridgework on teeth or implants. In conclusion, dental CBCT imaging could be justified when dealing with specific indications including jaw bone and maxillofacial surgery, endodontic retreatment, traumata, jaw bone lesions and TMJ pathology. Yet, guidelines for CBCT optimisation and justification are mandatory, especially when used for pediatric indications.

3-dimensional Analysis of Regenerative Endodontic Treatment Outcome

“…CBCT images overcome the limitations of 2D images including the lack of the buccolingual dimension, masking of areas of interest by overlying anatomy (anatomic noise), and avoiding geometric distortion. A high spatial resolution and true volumetric information can be obtained because of the isotropic nature of CBCT images (16,30). Moreover, it has been shown that dental trauma and developmental anomalies can be better assessed in 3 dimensions (16,(30)(31)(32).…”

“…A high spatial resolution and true volumetric information can be obtained because of the isotropic nature of CBCT images (16,30). Moreover, it has been shown that dental trauma and developmental anomalies can be better assessed in 3 dimensions (16,(30)(31)(32). Nevertheless, CBCT imaging has its own limitation; the effective radiation dose delivered by CBCT devices available in the market varies enormously from around 10-1200 mSv (which is an equivalent of 2-240 panoramic radiographs) (33,34).…”

“…Nevertheless, CBCT imaging has its own limitation; the effective radiation dose delivered by CBCT devices available in the market varies enormously from around 10-1200 mSv (which is an equivalent of 2-240 panoramic radiographs) (33,34). Therefore, a proper balance (optimization) between, on the one hand, costs and radiation dose and, on the other hand, information required needs to be maintained (16). Furthermore, the scanned area should not exceed the area of interest.…”

“…Taking into consideration the limitations of 2D imaging, 3-dimensional (3D) imaging using cone-beam computed tomographic (CBCT) imaging has proven itself as a valuable tool in dentistry (13)(14)(15) as long as radiation doses are controlled at reasonably low levels (16). Moreover, volumetric measurements from CBCT data have been reported and validated in several studies in vitro and in vivo (13)(14)(15)(17)(18)(19)(20).…”

Cone-beam CT to assess bony fusion following anterior cervical interbody fusion

“…CBCT was first developed as a tool for clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory [2]. In the intervening years, several CBCT systems have been developed for use both in the interventional suite as well as the originally intended general applications such as CT angiography [3,4].…”