Cone-beam computed tomography (CBCT) systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimetre resolution in images of high diagnostic quality, with short scanning times (10-70 seconds) and radiation dosages reportedly up to 15 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a 3-dimensional representation of the maxillofacial skeleton with minimal distortion. This article provides an overview of currently available maxillofacial CBCT systems and reviews the specific application of various CBCT display modes to clinical dental practice.

/pdf/clinical-applications-of-cone-beam-computed-tomography-in-4kp8tgr2p7.pdf

Clinical applications of cone-beam computed tomography in dental practice.

What is Cone-Beam CT and How Does it Work?

http://www.endoexperience.com/documents/DeVos2009.pdf

Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature.

Cone beam computed tomography (CBCT) has been specifically designed to produce undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a significantly lower effective radiation dose compared with conventional computed tomography (CT). Periapical disease may be detected sooner using CBCT compared with periapical views and the true size, extent, nature and position of periapical and resorptive lesions can be assessed. Root fractures, root canal anatomy and the nature of the alveolar bone topography around teeth may be assessed. The aim of this paper is to review current literature on the applications and limitations of CBCT in the management of endodontic problems.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2591.2008.01531.x

New dimensions in endodontic imaging: part 2. Cone beam computed tomography

Introduction: The aim of this systematic review was to analyze the dental literature regarding accuracy and clinical application in computer-guided template-based implant dentistry. Materials and methods: An electronic literature search complemented by manual searching was performed to gather data on accuracy and surgical, biological and prosthetic complications in connection with computer-guided implant treatment. For the assessment of accuracy meta-regression analysis was performed. Complication rates are descriptively summarized. Results: From 3120 titles after the literature search, eight articles met the inclusion criteria regarding accuracy and 10 regarding the clinical performance. Meta-regression analysis revealed a mean deviation at the entry point of 1.07 mm (95% CI: 0.76-1.22 mm) and at the apex of 1.63 mm (95% CI: 1.26-2 mm). No significant differences between the studies were found regarding method of template production or template support and stabilization. Early surgical complications occurred in 9.1%, early prosthetic complications in 18.8% and late prosthetic complications in 12% of the cases. Implant survival rates of 91-100% after an observation time of 12-60 months are reported in six clinical studies with 537 implants mainly restored immediately after flapless implantation procedures. Conclusion: Computer-guided template-based implant placement showed high implant survival rates ranging from 91% to 100%. However, a considerable number of technique-related perioperative complications were observed. Preclinical and clinical studies indicated a reasonable mean accuracy with relatively high maximum deviations. Future research should be directed to increase the number of clinical studies with longer observation periods and to improve the systems in terms of perioperative handling, accuracy and prosthetic complications.

/pdf/a-systematic-review-on-the-accuracy-and-the-clinical-outcome-4gvuyhusba.pdf

A systematic review on the accuracy and the clinical outcome of computer-guided template-based implant dentistry.

Objectives: Radiation doses were determined to balance risks against usefulness of the different modalities available for the imaging of the facial skeleton. Methods: An Alderson Rando Phantom, armed with lithium fluoride thermoluminescent dosemeters (TLDs) was exposed using a set of four conventional radiographs (orbital view, modified Waters view, orthopantomography, skull posterior–anterior 0°), two different cone beam computed tomography (CBCT) (NewTom 9000 and Siremobil Iso-C3D), and multislice computed tomography (CT) modalities (Somatom VolumeZoom and Somatom Sensation 16). TLDs from 14 well defined anatomical sites lying within the primary beam as well as the TLD corresponding to the thyroid gland were evaluated. Results: Multislice CT showed the highest exposure values. Exposure levels of the CBCT sytems lay between CT and conventional radiography. Dose measurement for the 16-slice CT revealed nearly the same radiation exposure as the 4-slice system when adapted examination protocols were used. C...

/pdf/radiation-exposure-during-midfacial-imaging-using-4-and-16-1v054a5ak3.pdf

Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography

Hintergrund
Die praoperative rontgenologische Diagnostik bei schwerkranken Patienten, bei denen nach dem klinischen Befund ein chirurgischer Sanierungsbedarf offensichtlich besteht, ist haufig nur unzureichend moglich. Mit dem SIREMOBIL Iso-C3D steht nun ein dreidimensionaler C-Bogen auch fur den intraoperativen Einsatz im Gesichtsschadel zur Verfugung. Diese Modalitat wurde bei zwei Patienten mit chirurgischem Sanierungsbedarf intraoperativ eingesetzt. Des Weiteren wurde die Strahlenexposition des SIREMOBIL Iso-C3D, einer Panoramaschichtaufnahme und eines kompletten konventionellen Rontgenstatus miteinander verglichen.

Strahlenexposition und dreidimensionale Darstellungsmöglichkeiten des SIREMOBIL Iso-C3D zur Planung chirurgischer Zahnsanierungen

BACKGROUND Preoperative dental X-ray diagnostics of multimorbid, non compliant patients requiring dental surgery are often insufficient. The SIREMOBIL Iso-C(3D) has made intraoperative 3D imaging available, even for the facial skeleton. This modality was used intraoperatively in two patients referred for surgical dental treatment. Furthermore, radiation exposure of the SIREMOBIL Iso-C(3D), an orthopantomography and a complete dental status was compared. MATERIAL AND METHODS An Alderson-Rando phantom was exposed to ten cycles of the SIREMOBIL Iso-C(3D) using the fast mode (50 projections). In comparison 28 panoramic views of an Orthophos and 10 sets of 14 dental images using the Oralix DC with a quadrate mask were applied. Twenty-five anatomically defined TLD positions were analyzed. Furthermore, SIREMOBIL Iso-C(3D) was used in one patient by performing 100 projections and in a second patient by performing 50 projections. After DICOM-import in eFilm, axial, coronal, and sagittal reconstructions were evaluated by five examiners regarding defined criteria. RESULTS The radiation exposure level of the SIREMOBIL Iso-C(3D) was lower than in the complete dental status and only slightly higher in comparison with the orthopantomography, although the system requires the highest number of single projections. Quantitative evaluation of the visualization and recognition of defined structures proved to be very good and good in most points. However, limitations of the system became obvious regarding apical processes. CONCLUSION Because of the dosimetry results and the visualization of the relevant structures, in patients for whom preoperative images cannot sufficiently be performed, the intraoperative use of the SIREMOBIL Iso-C(3D) as a base examination is justified.

[Radiation exposure and 3 dimensional imaging options of SIREMOBIL Iso-C(3D) for planning surgical dental interventions].

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Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography

Strahlenexposition und dreidimensionale Darstellungsmöglichkeiten des SIREMOBIL Iso-C3D zur Planung chirurgischer Zahnsanierungen

[Radiation exposure and 3 dimensional imaging options of SIREMOBIL Iso-C(3D) for planning surgical dental interventions].