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14 views10 pages

C2 2

Uploaded by

8pff6bsnvp
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© © All Rights Reserved
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Noor Al-Huda Haider Razzaq
Masarra Riyad Muhammad
Zahraa Hisham Habib
Zahraa Khaled Khalaf
CBCT
5. Fatima Ali Jabbar
Dr. jawadain majid
6. Fatima Ali Hamid
Dr. masar abdulkhaliq
Group D3
Dr. saja alasadi
Recent advances in imaging technologies in
dentistry

In the past three decades, dentistry has advanced


significantly, requiring more accurate diagnostic tools,
particularly in imaging. Techniques like CT, CBCT, MRI,
and
ultrasound have become essential. The shift to digital
radiography has made imaging faster, easier, and
improved
storage and manipulation.
3D imaging has enhanced the examination of complex
craniofacial structures, enabling early diagnosis of
deep
lesions. While 2D radiographs provide essential
information for
routine practice, they cannot assess the buccal-lingual
plane.
In complex cases, 3D imaging offers crucial additional
insights
for accurate diagnosis and treatment planning
CONE BEAM COMPUTED TOMOGRAPHY

This imaging technique is based on a cone-


shaped X-ray beam centered on a 2-D
detector. It performs one rotation around the
object and produces a series of 2-D
images which are re- constructed in 3-D
using a modification of the original
conebeam algorithm developed by
Aboudara et al in 1984. Major advantage of
CBCT over
CT is the considerably lower effective
radiation dose to which patients are
exposed.
Radiation dose of one cone beam computed
tomography (CBCT) scan may be as little
as 3%-20% that of a conventional CT scan,
depending on the equipment used and the
area scanned
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CBCT does not require an additional mechanism to move the
patient during the
acquisition. Cone beam technology significantly increases the X-
ray utilization and
requires far less electrical energy than fan-beam technology. X-
ray tubes of conebeam scanning are much less expensive than
that for conventional CT. CBCT provides
a high spatial resolution of bone and teeth which allows accurate
understanding of the
relationship of the adjacent structures.

CBCT is categorized into large, medium, and limited volume units


based on the size of
their field of view (FOV). The size of the FOV depicts the scan
volume of CBCT
machines. It depends on various factors like the size and shape
of the detector, beam
projection geometry and the ability to collimate the beam.
Collimation of the beam
limits the X-radiation exposure to the region of interest and
ensures the most favorable 4
FOV to be selected, based on disease presentation
APPLICATIONS OF CBCT IN VARIOUS BRANCHES OF DENTISTRY
Oral and maxillofacial surgery

CBCT is majorly used in oral and maxillofacial


surgery for surgical evaluation and planning
for surgery for impacted teeth, cysts and tumors

CBCT has been used for measuring the


thickness of the glenoid fossa .It often reveals
the
possible dislocation of the disk in the joint by
defining the true position of the condyle and
the extent of translation of the condyle in the
fossa .It has also been used for an image
guided puncture technique of the TMJ which is a
treatment modality for TMJ disk
adhesion .CBCT provides a dose and cost-
effective alternative to helical CT for the
diagnostic evaluation of osseous abnormalities
of the TMJ 5
Endodontics
CBCT is widely used in endodontics, aiding in diagnosing periapical lesions and
distinguishing cysts from granulomas by measuring lesion density. It provides
better detection of vertical root fractures compared to traditional radiographs
and is valuable for planning endodontic surgery and identifying root canals not visible on 2D images

CBCT image showing the missed canal in the mandibular


periapical lesions molar

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Implantology

CBCT has been used for preoperative and


postoperative dental implant assessment.
Preoperatively, it can accurately determine the
quantity and quality of bone available
for placement of implant

Orthodontics
CBCT images have been used in orthodontic
assessment .CBCT can provide
enhanced visualization of roots, making it a
valuable tool for assessing pre and
post-orthodontic root resorption.
CBCT evaluates the success of alveolar bone
grafts in patients with cleft lip and
palate by determining the bucco-palatal width
and allowing the visualization of
the 3-D morphology of the bone bridge

CBCT image of a patient with unilateral


cleft palate
LIMITATIONS OF CBCT

Image quality and diagnostic accuracy of CBCT is affected by the scatter and beam
hardening artifacts caused by high density structures such as enamel and
radiopaque
materials . Scatter radiation reduces the contrast and limits the imaging of soft
tissues. Hence, CBCT is principally indicated for imaging hard tissues
Scan times for CBCT are lengthy at 15-20 s and require the patient to stay
completely still

CONCERN FOR RADIATION EXPOSURE

Intraoral films are available in D, E, and F speeds, with F being the fastest and
requiring the least radiation. Despite minimal cost differences, many dentists use D
speed films. Digital X-rays reduce radiation by 50-75% compared to film.
Panoramic and cephalogram radiographs have lower radiation doses (0.020 mSv
and 0.007 mSv, respectively), while CBCT scans range from 87-206 mSv.

However, CBCT must not be used routinely for dental diagnosis or for screening
purposes. The patient’s history and clinical examination must validate the use of
CBCT by demonstrating that the benefits to the patient offset the potential risks.
CBCT should only be used when lower dose conventional dental radiographs fails
to provide adequate diagnostic information.
References

_ White S, Pharoah M. Chapter 13. Advanced Imaging Modalities. Oral Radiology: Principles and Interpretation. 5th ed. Mosby: St
Louis, MO; 2004. pp. 245–264. [
_ Aboudara CA, Hatcher D, Nielsen IL, Miller A. A three-dimensional evaluation of the upper airway in adolescents. Orthod Craniofac Res.
2003;6 Suppl 1:173–175.
_ Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. Int J Dent. 2009;2009:634567.
_Tyndall DA, Kohltfarber H. Application of cone beam volumetric tomography in endodontics. Aust Dent J. 2012;57 Suppl 1:72–81.
_ Kijima N, Honda K, Kuroki Y, Sakabe J, Ejima K, Nakajima I. Relationship between patient characteristics, mandibular head morphology
and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints. Dentomaxillofac Radiol. 2007;36:277–281.
_ Tsiklakis K, Syriopoulos K, Stamatakis HC. Radiographic examination of the temporomandibular joint using cone beam computed
tomography. Dentomaxillofac Radiol. 2004;33:196–201.
_ Honda K, Bjørnland T. Image-guided puncture technique for the superior temporomandibular joint space: value of cone beam computed
tomography (CBCT) Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:281–286.
_ Simon JH, Enciso R, Malfaz JM, Roges R, Bailey-Perry M, Patel A. Differential diagnosis of large periapical lesions using cone-beam
computed tomography measurements and biopsy. J Endod. 2006;32:833–837.
_ Hatcher DC, Dial C, Mayorga C. Cone beam CT for pre-surgical assessment of implant sites. J Calif Dent Assoc. 2003;31:825–833.
_ Hamada Y, Kondoh T, Noguchi K, Iino M, Isono H, Ishii H, Mishima A, Kobayashi K, Seto K. Application of limited cone beam computed
tomography to clinical assessment of alveolar bone grafting: a preliminary report. Cleft Palate Craniofac J. 2005;42:128–137.
_ Katsumata A, Hirukawa A, Noujeim M, Okumura S, Naitoh M, Fujishita M, Ariji E, Langlais RP. Image artifact in dental cone-beam CT.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:652–657
_ Silva MA, Wolf U, Heinicke F, Bumann A, Visser H, Hirsch E. Cone-beam computed tomography for routine treatment planning:
a radiation dose evaluation. Am J Orthod Dentofacial Orthop. 2008;133:640.e1–640.e

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