Indian Journal of Ophthalmology

GUEST EDITORIAL
Year
: 2020  |  Volume : 4  |  Issue : 2  |  Page : 76-

Necessity of cone-beam computed tomography - An introduction and oral radiologist sketch


Ahmad Badruddin Ghazali 
 Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia

Correspondence Address:
Ahmad Badruddin Ghazali
Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang
Malaysia




How to cite this article:
Ghazali AB. Necessity of cone-beam computed tomography - An introduction and oral radiologist sketch.Saint Int Dent J 2020;4:76-76


How to cite this URL:
Ghazali AB. Necessity of cone-beam computed tomography - An introduction and oral radiologist sketch. Saint Int Dent J [serial online] 2020 [cited 2021 Apr 19 ];4:76-76
Available from: https://www.sidj.org/text.asp?2020/4/2/76/308182


Full Text

Besides panoramic radiograph, cone-beam computed tomography (CBCT) can be acknowledged as one of the most crucial technologic achievements in dentistry. It utilizes the cone-shaped or pyramid-shaped X-ray source and can be viewed in multiplanar images, providing a three-dimensional view of the maxillofacial region.[1] The machine has a relatively small size, but it generates more radiation dose than other conventional dental imaging modalities[2] while lower than the medical CT. The radiation dose depends on several factors, such as field of view (FOV) size and other technical factors such as the resolution of the image.[3] There are many applications of CBCT in the dental clinic. It is advantageous to use treatment planning in oral surgery cases such as an impacted tooth, implant planning, orthodontics, periodontics, temporomandibular joint diseases, CBCT sialography, obstructive sleep apnea, and other maxillofacial pathology imaging.[1],[4]

CBCT has a separate limitation that clinicians should be aware of. It is sensitive to patient motion during the acquisition phase, having noise and low soft-tissue contrast compared to conventional medical CT and having metallic artifacts with beam hardening, scatter, and cupping appearance.[1] All clinicians should be aware of the guidelines on CBCT imaging. There were 26 guidelines on the use of CBCT found in 2015, and there might be more in 2020. These guidelines include the patient selection criteria, the clinical use of CBCT in the dental setting, and various aspects of the tomographic radiology technique. CBCT should not be a routine examination. Each case should be selected individually and only used when necessary to balance the risk of exposing the patient to ionizing radiation. Children are more radiosensitive than adults; thus, choosing CBCT cases in children must be justified. A dentist prescribing CBCT must be responsible for the image taken.[4]

Dentists with CBCT machines must have proper training, especially regarding selection criteria and “As Low As Reasonably Achievable” principles. Sole training by salespeople should be avoided.[3] Concerning the COVID-19 pandemic, all clinicians should follow the established guideline when prescribing a radiographic examination. Each patient should be screened beforehand to ensure the safety of healthcare providers and other patients. Patient selection, precautions during the radiographic examination, and postimaging room cleaning should be made. Small FOV CBCT might be considered one imaging modality since it does not induce aerosol from gagging.[2] The recently published guideline should be read carefully by each clinician and followed thoroughly to prevent infection spread.

References

1Mallya SM, Lam EW, editors. White and Pharoah's Oral Radiology Principles and Interpretation. 8th ed.. St. Louis, Missouri: Elselvier; 2019.
2MacDonald DS, Colosi DC, Mupparapu M, Kumar V, Shintaku WH, Ahmad M. Guidelines for oral and maxillofacial imaging: COVID-19 considerations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jan;131(1):99-110. doi: 10.1016/j.oooo.2020.10.017. Epub 2020 Oct 26. PMID: 33248906; PMCID: PMC7586124.
3Lurie AG, Kantor ML. Contemporary radiation protection in dentistry: Recommendations of National Council on Radiation Protection and Measurements Report No. 177. J Am Dent Assoc 2020;151:716-9.e3.
4Scarfe WC, Angelopoulos C, editors. Maxillofacial Cone Beam Coputed Tomography Principles, Techniques and Clinical Applications. Cham, Switzerland: Springer; 2018.