IAEA survey of dental cone beam computed tomography practice and related patient exposure in nine Central and Eastern European countries

Beganović, Adnan; Ciraj-Bjelac, Olivera; Dyakov, I.; Gershan, Vesna; Kralik, Ivana; Milatović, Aleksandra; Salát, D.; Stepanyan, Karapet; Vladimirov, Anatoli; Vassileva, J.

doi:10.1259/dmfr.20190157

Cited by 8 publications

(10 citation statements)

References 20 publications

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“…Widely varying non-optimised doses were also found for example in the SEDENTEXCT research project [40] and in the European DIMITRA (dentomaxillofacial paediatric imaging: an investigation toward lowdose radiation induced risks) project [50]. A recent study by the IAEA [51] revealed that optimisation in dental and maxillofacial CBCT imaging was still not at a mature stage, 7 years after the publication of SEDENTEXCT guidelines. This conclusion was also supported by a survey performed by the EURADOS working group 12 [47].…”

Section: Patient Dose and Optimisation Aspectsmentioning

confidence: 99%

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Dental cone beam CT: An updated review

et al. 2021

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Cone beam computed tomography (CBCT) is a diverse 3D x-ray imaging technique that has gained significant popularity in dental radiology in the last two decades. CBCT overcomes the limitations of traditional twodimensional dental imaging and enables accurate depiction of multiplanar details of maxillofacial bony structures and surrounding soft tissues. In this review article, we provide an updated status on dental CBCT imaging and summarise the technical features of currently used CBCT scanner models, extending to recent developments in scanner technology, clinical aspects, and regulatory perspectives on dose optimisation, dosimetry, and diagnostic reference levels. We also consider the outlook of potential techniques along with issues that should be resolved in providing clinically more effective CBCT examinations that are optimised for the benefit of the patient.

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Section: Patient Dose and Optimisation Aspectsmentioning

confidence: 99%

“…CBCT dosimetry still lacks a consensus on dose metrics at a practical level (KAP vs. CTDI, or some other dose quantity) [47,51]. This may also have implications on optimisation, as comparisons of dose levels between clinics, or even between different vendors or models, may be difficult.…”

Section: Dosimetry and Use Of Diagnostic Reference Levelsmentioning

confidence: 99%

Dental cone beam CT: An updated review

et al. 2021

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“…An additional consideration is the wide range in image quality and radiation dose between CBCT machines, or between different exposure protocols of a CBCT unit. The imaging performance of CBCT is dictated by several factors, including but not limited to kV, mAs, and voxel size, which are not standardized between manufacturers or clinics 15,16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…While the diagnostic bene t of CBCT over 2D radiography is demonstrable, one should also consider the radiation risk 15 . An additional consideration is the wide range in image quality and radiation dose between CBCT machines, or between different exposure protocols of a CBCT unit.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Intra-oral Radiography and Cone-beam CT in the Diagnosis of Buccal Bone Loss.

Christiaens

Pauwels

Mowafey

et al. 2021

Preprint

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BackgroundThe use of Cone Beam Computed Tomography (CBCT) in dentistry started in the maxillofacial field, where it was used for complex and comprehensive treatment planning. Due to the reduced radiation dose compared to a Computed Tomography (CT) scan, CBCT has become a frequently used diagnostic tool in dental practice. However, published data on the accuracy of CBCT in the diagnosis of the buccal bone level is lacking. The aim of this study was to compare the accuracy of intra-oral radiography (IOR) as well as CBCT in the diagnosis of the extent of buccal bone loss.MethodsA dry skull was used to create a buccal bone defect at the most coronal level of a first premolar; the defect was enlarged apically in steps of 1 mm. After each step, IOR and CBCT were taken. Based on CBCT data 2 observers jointly selected 3 axial slices at different levels of the buccal bone, as well as one transverse slice. Six dentists participated in radiographic observations. First, all observers received the 10 intra-oral radiographs and each observer was asked to rank the intra-oral radiographs on the extent of the buccal bone defect. Afterwards, the procedure was repeated with the CBCTs based on a combination of axial and transverse information. For the second part of the study, each observer was asked to evaluate axial as well as transverse CBCT slices on the presence or absence of a buccal bone defect. ResultsThe percentage of buccal bone defect progression rankings that were within 1 of the true rank was 32% for IOR and 42% for CBCT. On average, kappa values were increased by 0.384 for CBCT compared with intra-oral radiography. The overall sensitivity and specificity of CBCT in the diagnosis of the presence or absence of a buccal bone defect was 0.89 and 0.85, respectively. The average area under the curve (AUC) of the ROC was 0.892 for all observers.ConclusionWhen CBCT images are available for justified indications, other than bone level assessment, such 3D images are more accurate and thus preferred to 2D images to assess periodontal buccal bone. For other clinical applications, intra-oral radiography remains the standard method for radiographic evaluation.

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“…CBCT guidelines in the North America conclude that the selected field-of-view (FOV) is an important consideration to reduce to dose to the patient [ 16 ]. The size and positioning of FOV affect the effective radiation dose [ 8 , 10 , 11 , 17 ]. Using small FOV (< 10 cm height), compared to large FOV sizes (> 15 cm height), the mean effective doses could decrease by 60% [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Minimum size and positioning of imaging field for CBCT-scans of impacted lower third molars: a retrospective study

et al. 2021

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Background Cone-beam Computed Tomography (CBCT) is widely used for preoperative 3D imaging of lower third molars. Hence, for this imaging indication, the present study aimed to define the minimum field-of-view (FOV) size and its optimum placement, to decrease radiation exposure, and highlight the need of computer-assisted FOV centering technique for dental CBCT devices. To facilitate proper placement of image field, lower second molar was chosen as reference. Methods The retrospective study included 50 CBCT-scans of 46 patients with mean age of 34 years. Based on the lower second molar, a three-dimensional coordinate was formed and the location of mandibular canal (MC) and the dimensions and locations of the lower third molars, and possible associated pathological findings were assessed. Accordingly, the FOV size and position for third-molar imaging were optimized, while ensuring encompassment of all relevant structures. Results The minimum cylindrical volume, covering lower third molars and MC, was 32.1 (diameter) × 31.6 (height) mm, placed in relation to the second molar crown, top 2.2 mm above cusp tips, anterior edge 6.7 mm in the front of the most distal point of the crown, and lingual edge 7.9 mm on the medial side of the lingual wall. Conclusions The optimized FOV for lower third molars was smaller than common standard small FOVs. We recommend using FOV volume 3.5∅ × 3.5 cm for third molars without associated pathology. Accurate FOV protocols are essential for development of new CBCT-devices with computer-assisted and indication-specific FOV placement.

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IAEA survey of dental cone beam computed tomography practice and related patient exposure in nine Central and Eastern European countries

Cited by 8 publications

References 20 publications

Dental cone beam CT: An updated review

Dental cone beam CT: An updated review

Accuracy of Intra-oral Radiography and Cone-beam CT in the Diagnosis of Buccal Bone Loss.

Minimum size and positioning of imaging field for CBCT-scans of impacted lower third molars: a retrospective study

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