Use of CBCT in Dentistry

Expert Author
Dr. Jayme Oliveira Filho Dentist Chesapeake, VA

Dr. Jayme A. Oliveira Filho (Dr. O) was born in Brazil on 1976. He finished his dental school at Federal University of Ceara School of Dentistry in 1999. Dr. O practiced dentistry in Brazil for 5 years until, where he did his post-graduation in dental prosthetics. He moved with his family to the United States in 2003 to... more

Cone Beam Computed Tomography (CBCT), also known as Cone Beam Volumetric Tomography (CBVT), is a type of radiographic imaging method that is now widely used in dentistry. It provides three-dimensional images of the teeth, oral, and maxillofacial region in a single scan, allowing for a more precise diagnosis and treatment planning. Here are some key applications and benefits of CBCT in dentistry:

Applications:

  1. Dental Implant Planning: CBCT is crucial for implantology, as it allows for accurate assessment of bone quality, quantity, and anatomical structures, ensuring precise placement of dental implants. This is vital for avoiding vital structures like the inferior alveolar nerve or maxillary sinus.
  2. Endodontics: CBCT can visualize the intricate anatomy of root canals, detect root fractures, and identify periapical pathology, which might be challenging to diagnose with conventional two-dimensional X-rays.
  3. Orthodontics: CBCT provides detailed views of the maxillofacial skeleton, aiding in orthodontic diagnosis, treatment planning, and post-treatment assessment. It's especially useful for understanding impacted teeth and jaw anomalies.
  4. Oral and Maxillofacial Surgery: Surgeons use CBCT to plan and visualize complex surgical procedures, such as the removal of impacted teeth, cysts or tumors, and reconstructive surgeries.
  5. Temporomandibular Joint (TMJ) Analysis: CBCT can provide detailed images of the TMJ, helping in diagnosing disorders, understanding the relationship between the condyle and fossa, and planning for surgeries if needed.
  6. Periodontics: CBCT helps in assessing bone loss, the morphology of bony defects, and the relationship between dental and anatomical structures, which is crucial for procedures like guided tissue regeneration.
  7. Airway Assessment: For patients with sleep apnea or other airway disorders, CBCT can provide valuable information about the airway anatomy and potential obstructions.
  8. Trauma: CBCT can help in the assessment and management of facial fractures, offering a detailed and comprehensive view of the affected area.

Advantages:

  1. High Resolution: CBCT offers detailed, three-dimensional images with high spatial resolution.
  2. Lower Radiation Dose: Compared to traditional medical CT scans, CBCT typically exposes patients to a lower radiation dose.
  3. Compact and Accessible: CBCT machines are more compact than conventional CT machines, making them suitable for dental clinics.
  4. Short Scan Time: CBCT scans are usually quick, often taking less than a minute, which enhances patient comfort.

Limitations:

  1. Radiation Concerns: Even though the radiation is less than traditional CT, it's still higher than standard dental X-rays. Hence, CBCT should be used judiciously, adhering to the ALARA (As Low As Reasonably Achievable) principle.
  2. Cost: CBCT equipment and scans can be expensive, which might be reflected in the treatment cost for patients.
  3. Artifacts: Metallic restorations or appliances in the mouth can cause artifacts in the CBCT images, potentially affecting image quality.

In conclusion, CBCT has become an indispensable tool in modern dentistry, providing detailed three-dimensional images that aid in diagnosis, treatment planning, and post-treatment assessment across various dental specialties. However, like all radiographic tools, it should be used judiciously, keeping the patient's best interest in mind.