CBCT in dentistry
CBCT in dentistry is becoming much more common and the benefits are obvious. However, one must balance those benefits against the additional exposure of radiation.
Professional organizations stance on CBCT use in dentistry
AAE and AAOMR came out with a joint statement in 2015 stating that in the absence of clinical signs an symptoms, routine use of CBCT for diagnosis is not recommended.
AAOMR recommends cross sectional imaging for dental implants since 2000
“Because the 3D information obtained with CBCT cannot be obtained with other 2D imaging modalities, it is virtually impossible to predict which treatment cases would not benefit from having this additional information before obtaining it.” Benavides et al So basically it’s not the standard of care but after you make an avoidable surgical mistake during dental implant placement, it does the patient no good to say this could have been avoided with a CBCT.
AAE position is to not use for routine cases but to use if retreat, complex anatomy (subjective), suspected root fracture, or root resorption.
AAO has a CYA position of basically use your clinical judgment.
AAOMR recommends entire data set is reviewed
Common findings include maxillary sinus mucosa, antral pseudocyst, concha bullosae link to surgery but I think a laser would be even better, tonsiliths 2, enostoses, TMJ remodeling, and undiagnosed PA pathology.
A list of the cone beam computed tomography units available for dentistry today
Following list includes many of the companies offering CBCT units in US and EU. Units with only one company name likely not available in US.
I personally use the iCAT FLX
- Asahi Roetgen (AUGE ZIO)
- Biolase (Biolase DaVinci)
- Carestream (CS)
- Gendex (Gendex GX)
- Imaging Sciences (i-CAT)
- Imtec 3M
- Instrumentarium (Orthopantomograph)
- J.Morita (3D Accuitomo. Veraviewepocs)
- MyRay (Hyperion, Skyview)
- Oy Ajat
- Planmeca (Promax)
- PreXion (PreXion 3D)
- Quatitative Radiology
- Ritter Imaging
- Sirona (Galileos, Orthophos)
- Soredex (Cranex, Scanora)
- Suni (Suni 3D)
- Vatech (Pax, Picasso)
- Xoran Technologies (xCAT ENT)
CBCT in dentistry comparison research
CBCT for endodontics
PreXion 3D > iCAT Next Gen and Classic at canal location. PX1 setting similar dignositc with less ration than PX2 setting. Vavassori de Freitas JOE 2017
The Next Generation i-CAT was the most accurate system, followed by the Scanora 3D. The other three systems, Galileos 3D, NewTom 3G, and AccuiTomo-XYZ, were significantly less accurate in detecting vertical root fractures. Hassan JOE 2010