Three-dimensional, high-resolution imaging is a reality in dentistry. With the advent of Cone Beam Computed Tomography (CBCT), implants can be placed with unparalleled accuracy, third molar surgery can be planned with precise knowledge of mandibular nerve location, and accurate diagnosis and treatment planning can now be accomplished at one time and in one location. Cone beam CT imaging is quickly becoming the standard of care in oral surgical procedures, orthodontics, and in implant dentistry. Cone beam CT scanners are similar in size and appearance to panoramic X-ray units, yet they offer many more applications using high resolution with low radiation exposure to patients.
This issue of THE DENTAL ADVISOR will explore cone beam CT scanning, define the terminology of this new treatment modality, and provide a guide for dentists considering purchasing a cone beam CT scanner.
What is Cone Beam Computed Tomography (CBCT)?
For many years, dental professionals have relied on intraoral radiography, panoramic radiography, and conventional tomography for diagnosis and treatment planning. These commonly used imaging modalities produce only two-dimensional and/or distorted images with superimposition of structures outside the area of interest. There has always been a need for three-dimensional (3-D) imaging, but the technology has only recently become readily available. Cone Beam Computed Tomography (CBCT) uses a cone-shaped beam and digital processing to reconstruct a virtually distortion-free 3-D image using a single rotation in a sitting/standing position, similar to that of a panoramic radiograph. CBCT scanners are compact in size, capable of producing high-resolution 3-D imaging of hard tissues, and are compatible with computer-aided imaging software for improved diagnosis and treatment planning.
Clinical applications of CBCT imaging
- Implant planning and site development
- Extractions — helps determine location of nerves, sinus, and roots
- Orthodontia — jaw symmetry, configuration of roots, impacted canines
- Maxillofacial — orthognathic surgery, fractures, jaw pathology
- Periodontics — sinus augmentation, advanced grafting procedures, periodontal defects
- Endodontics — canal measurements, additional canals, configuration of root canals
- TMJ/TMD — detection of bony defects, asymmetry, spurs, condylar changes
- ENT specialists — sinus and airway studies
Benefits of CBCT imaging
- Imaging exposes patients to less radiation than traditional CT scans.
- The scan is fast and comfortable to the patient.
- Reduction in metal artifacts.
- One scan produces a volume of images that can be viewed and manipulated.
- Clinicians can illustrate recommended treatment plans to patients using 3-D software.
- No superimposition and minimal distortion.
- Allows clinician to visualize internal anatomy that cannot be diagnosed externally.
- Lower cost for patient when compared to traditional CT.
- Enhanced communication with patients and colleagues.
Factors to consider in the use of CBCT
The decision to incorporate Cone Beam CT technology into a dental practice is one that requires serious consideration and careful planning. CBCT scanners are relatively easy to use and maintain. However, with new technology comes new responsibility. Unlike most traditional X-rays, CBCT scans can reveal medical problems. If dentists decide to read their own scans, they become responsible for all findings. This could pose potential legal liability. Many practitioners who are not comfortable diagnosing medical issues send their X-rays to oral and maxillofacial radiologists for interpretation.
Regulations for running a CBCT system vary from state to state. If you are considering purchasing a unit, it is important to contact your state board first to ensure that you will be permitted to run your system.
To read more including CBCT Specifications, Options and Clinical Success Tips, visit www.dentaladvisor.com.