ALL YOU WANTED TO KNOW ABOUT CBCT
CBCT is a useful tool for imaging the craniofacial area that produces more realistic images that facilitate interpretation. All the previous conventional and digital intraoral and extraoral procedures, as they were two dimensional (2D) projections, suffer from several limitations. These limitations were magnification, distortion, superimposition and misrepresentation of structures. CBCT has achieved a transition of dental imaging from 2D to 3D images. Moreover, the application of sophisticated software, contribute to the reestablishment of imaging sciences role Dental Clinical Applications of CBCT
As with any X-ray exposure, CBCT entails a risk to the patient. It is essential that any X-ray examination should show a net benefit to the patient, weighing the total potential diagnostic benefits it produces against the individual detriment that the exposure might cause. The efficacy, benefits and risk of available alternative techniques having the same objective but involving less (or no) exposure to X-rays should be taken into account (1). In order that the justification process can be carried out, it is essential that selection of CBCT is based on the individual patient’s history and a clinical examination. The ‘routine’ use of CBCT on patients based on a generalized approach rather than individual prescription is unacceptable. A ‘routine’ (or ‘screening’) examination is defined as one in which a radiograph is taken regardless of the presence or absence of clinical signs and symptoms (1). Choosing CBCT for a patient should also be based upon consideration of the prevalence of diseases, their rates of progression and the diagnostic accuracy of CBCT, compared with traditional techniques, for the application in question. The following are the uses of CBCT in Pediatric dentistry. 1. The Developing dentition
Many children seek orthodontic treatment. Usually the treatment starts at the time period of mixed dentition stage. Orthodontic patients may present abnormalities in eruption pattern, tooth position or signs of crowding. Radiographs may be required to determine the presence, absence, position and condition of teeth. Justification of X-ray examinations in children is especially important because of the higher risks associated with exposure in children. Traditional radiological examination of children undergoing orthodontic assessment includes a panoramic radiograph, supplemented by a lateral cephalometric radiograph in specific circumstances. Intra-oral radiographs are also used according to patient-specific needs. In recent years, however, the availability of CBCT has led to this technique being used by some clinicians as a means of radiological examination. For assessment of facial bone shape, position and inter-relationships, there must be a high accuracy of measurements made with CBCT. The applications of CBCT in assessment of the developing dentition will be considered under two broad headings: localized applications to answer a specific question and generalized application for examination of the entire dento-facial region (1).
1.1. Localized applications of CBCT for the developing dentition 1.1.1 Unerupted tooth localization
A frequent application of CBCT is for assessment of the position of an unerupted tooth, particularly where the tooth is impacted. Impaction is defined as a failure of tooth eruption at its appropriate site in the dental arch within the normal period of growth based on clinical and radiographic assessment. Third molars are the most frequently impacted teeth, followed by the permanent maxillary canines. Impacted third molar and related symptoms are a frequent problem that the dental practitioner has to deal with. In cases that the anatomy of the third molar is not extremely abnormal and the tooth in not correlated with the mandibular canal, surgical procedure is not a hazard. In cases concerning the lower third molar in which there is a relationship...
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