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CBCT for Dentists

Cone Beam Computed Tomography is one of the most modern Diagnostic Tools in Dentistry and can be used for many aspects of dentistry as follows:


Implant Dentistry                                                                                                                                                                                    

CBCT scans are the most useful diagnostic tool for determining the three dimensions of bone which helps to plan accurately all types of dental Implant treatment. Also they are extremely useful for finding the local anatomical sites in the oral cavity providing safe and predictable Implant treatment.
 European Guideline:
“CBCT is indicated for cross-sectional imaging prior to implant placement as an alternative to existing cross-sectional techniques where the radiation dose of CBCT is shown to be lower”
“For cross-sectional imaging prior to implant placement, the advantage of CBCT with adjustable fields of view, compared with MSCT, becomes greater where the region of interest is a localised part of the jaws, as a similar sized field of view can be used”


Periodontal Diagnosis                                                                                                                                                                          

CBCT scans are superior to intraoral radiographs for complex (crater and furcation) defect imaging, but not generally required for periodontal diagnosis.
European Guideline:
“Limited volume, high resolution CBCT may be indicated in selected cases of infra-bony defects and furcation lesions, where clinical and conventional radiographic examinations do not provide the information needed for management”
“CBCT is not indicated as a routine method of imaging periodontal bone support”

Endodontics                                                                                                                                                                                            

Diagnostic Accuracy studies suggest, CBCT detects more periapical lesions than conventional radiography.
European Guideline
“Limited volume, high resolution CBCT may be indicated for periapical assessment, in selected cases, when conventional radiographs give a negative finding when there are contradictory positive clinical signs and symptoms”
“Limited volume, high resolution CBCT may be indicated, for selected cases where conventional intraoral radiographs provide information on root canal anatomy which is equivocal or inadequate for planning treatment, most probably in multi-rooted teeth”
“Limited volume, high resolution CBCT may be indicated for selected cases when planning surgical endodontic procedures. The decision should be based upon potential complicating factors, such as the proximity of important anatomical structures”


Dento-Alveolar Trauma                                                                                                                                                                        

CBCT offers increased accuracy in detection of horizontal and vertical root fractures.
European Guideline:
“Limited volume, high resolution CBCT is indicated in the assessment of dental trauma (suspected root fracture) in selected cases, where conventional intraoral radiographs provide inadequate information for treatment planning”


Third Molars                                                                                                                                                                                            

CBCT is significantly superior to panoramic images in predicting neurovascular bundle exposure during extraction of impacted third molar teeth.
European Guideline:
“Where conventional radiographs suggest a direct inter-relationship between a mandibular third molar and the mandibular canal, and when a decision to perform surgical removal has been made, CBCT may be indicated”


Temporomandibular Joint                                                                                                                                                                  

CBCT has similar accuracy to Computed Tomograpy and greater accuracy than panoramic radiography/ conventional tomography for detection of osseous abnormaility.
European Guideline:
“Where the existing imaging modality for examination of the TMJ is MSCT, CBCT is indicated as an alternative where radiation dose is shown to be lower”


Orthodontics                                                                                                                                                                                          

There is a lot of Literature relating the use of three dimensional imaging in orthognathic surgery.
European Guideline:
“For complex cases of skeletal abnormality, particularly those requiring combined orthodontic/surgical management, large volume CBCT may be justified in planning the definitive procedure, particularly where MSCT is the current imaging method of choice”
“CBCT is indicated where bone information is required, in orthognathic surgery planning, for obtaining three-dimensional datasets of the craniofacial skeleton”


Unerupted Teeth                                                                                                                                                                                    

CBCT can give an accurate position of an unerupted tooth when planning further treatment and proximity to other vital anatomical structures.
European Guideline
“CBCT may be indicated for pre-surgical assessment of an unerupted tooth in selected cases where conventional radiographs fail to provide the information required”

 

 

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