Bir Türk Diş Hekimliği Fakültesinde Çocuk Hastalarda Konik Işınlı Bilgisayarlı Tomografi Kullanımı

Öz

Amaç: Bu çalışmanın amacı, çocuk hastalarda konik-ışınlı bilgisayarlı tomografi (KIBT) görüntülemenin planlanmasına yardımcı olabilecek bilgiler sağlamaktır. Bu çalışma, bir Türk dişhekimliği fakültesindeki çocuk hastalarda KIBT endikasyonlarının değerlendirilmesini amaçlamaktadır. Yöntem: Bu çalışmaya 16 yaş altı hastalara ait 607 KIBT taraması dahil edildi. Aşağıda sıralanan veriler, elektronik hasta veri tabanından kaydedildi: yaş, cinsiyet, sevk endikasyonu (gömülü dişler, süpernümere dişler, travma, kistler/tümörler, yarıklar, temporomandibular eklem ve diğer nedenler), sevklerin bölümlere göre dağılımı, dış veya iç sevkler. Bulgular: Ortalama yaş 12.39 idi [aralık: 4-16; 260 kadın (%42,8) ve 347 erkek (%57,2)]. En sık ve en büyük yaş grubu (%54,2) 13-16 yaş aralığıydı. En sık talep nedeni gömülü diş ve lokalizasyonunun değerlendirilmesiydi (%38,2). FOV'lar incelendiğinde en sık görüntülenen alan maksillaydı (%27.2). Dört yüz altmış altı hasta (%76.8) dişhekimliği fakültesi bölümlerinden, 141 hasta (%23.2) dış kliniklerden sevk edilmişti. Hasta hareket artefaktları nedeniyle 52 olguda (%8,6) yeniden çekim yapılmıştı. Sonuç: Bu çalışmanın sonuçları, diş hekimlerinin çocuk hastada ekstra üç boyutlu görüntüleme gerektiğinde KIBT'ye başvurma kararını vermelerine yardımcı olabilir. Bir oral ve maksillofasiyal radyologun KIBT'nin ne zaman gerekli olduğuna karar vermesi ve ardından çocuk hastalarda radyasyon dozunu en aza indirmek için KIBT tarama protokolünü denetlemesi uygun olabilir.

Anahtar Kelimeler

• Çocuk diş hekimliği
• Endikasyon
• Konik ışınlı bilgisayarlı tomografi
• Maksillofasiyal radyoloji

Use of Cone-Beam Computed Tomography in Pediatric Patients in a Turkish Dental School

Abstract

Objectives: The purpose of the present study was to provide information that might help in planning cone-beam computed tomography (CBCT) imaging in pediatric patients. This study focused on the evaluation of indications for CBCT in pediatric patients in a Turkish dental school. Method: Six-hundred-seven CBCT scans belonged to patients under the age of 16 were included in this study. The following data were recorded from an electronic patient database: age, gender, indication for referral (impacted teeth, supernumerary teeth, trauma, cysts/tumors, clefts, temporomandibular joint, and other reasons), dispersion of referrals by departments, external or internal referral. Results: Mean age was 12.39 years [range: 4-16; 260 females (42.8%) and 347 males (57.2%)]. The most frequent and largest age group (54.2%) was 13- to 16-years old. The most frequent request was to assess an impacted tooth and its localization (38.2%). Examining the FOVs, the maxilla was the most frequently imaged area (27.2%). Four-hundred sixty-six patients (76.8%) had been referred from departments of the dental school while 141 (23.2%) patients were referred from external clinics. Re-exposure was required in 52 cases (8.6%) due to patient-motion artefacts. Conclusion: The results of the present study can help dental professionals make the decision to refer for CBCT when extra three dimensional imaging is necessary for a pediatric patient. It might be proper that an oral and maxillofacial radiologist decides when CBCT is necessary and then supervises the CBCT-scanning protocol to minimize the radiation dose to pediatric patients.

Keywords

• Cone-beam computed tomography
• Indication
• Maxillofacial radiology
• Pediatric dentistry

References

1. 1. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006; 72(1): 75.
2. 2. Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: Combining digital technologies. Imaging Sci Dent. 2019; 49(3): 179-90.
3. 3. Tatli U, Evlice B. Cone-Beam Computed Tomography for Oral and Maxillofacial Imaging. Computed Tomography: Advanced Applications. 2017: 139.
4. 4. Aps J. Cone beam computed tomography in paediatric dentistry: overview of recent literature. Eur Arch Paediatr Dent. 2013; 14(3): 131-40.
5. 5. Valentin J. The 2007 recommendations of the international commission on radiological protection. Elsevier; 2008.
6. 6. Oenning AC, Jacobs R, Pauwels R, Stratis A, Hedesiu M, Salmon B et al. Cone-beam CT in paediatric dentistry: DIMITRA project position statement. Pediatric Radiology. 2018; 48(3): 308-16.
7. 7. Yeung AW, Jacobs R, Bornstein MM. Novel low-dose protocols using cone beam computed tomography in dental medicine: a review focusing on indications, limitations, and future possibilities. Clin Oral Investig. 2019; 23(6): 2573-81.
8. 8. Wanderley VA, de Faria Vasconcelos K, Leite AF, Oliveira ML, Jacobs R, editors. Dentomaxillofacial CBCT: Clinical Challenges for Indication-oriented Imaging. Semin Musculoskelet Radiol; 2020: Thieme Medical Publishers.

9. 9. Jadu FM, Jan AM. Referral pattern to a university-based oral and maxillofacial cone beam CT service. Indian J Dent Res. 2019; 30(4): 544.
10. 10. Schulze RK, Drage N. Cone-beam computed tomography and its applications in dental and maxillofacial radiology. Clin Radiol. 2020; 75(9): 647-57.
11. 11. Hajem S, Brogårdh-Roth S, Nilsson M, Hellén-Halme K. CBCT of Swedish children and adolescents at an oral and maxillofacial radiology department. A survey of requests and indications. Acta Odontol Scand. 2020; 78(1): 38-44.
12. 12. Marcu M, Hedesiu M, Salmon B, Pauwels R, Stratis A, Oenning ACC et al. Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D. Int J Paediatr Dent. 2018; 28(3): 300-9.
13. 13. İşman Ö, Yılmaz HH, Aktan AM, Yilmaz B. Indications for cone beam computed tomography in children and young patients in a Turkish subpopulation. Int J Paediatr Dent. 2017; 27(3): 183-90.
14. 14. Petersen LB, Olsen KR, Matzen LH, Vaeth Ma, Wenzel A. Economic and health implications of routine CBCT examination before surgical removal of the mandibular third molar in the Danish population. Dentomaxillofac Radiol. 2015; 44(6): 20140406.
15. 15. Ludlow J, Timothy R, Walker C, Hunter R, Benavides E, Samuelson D et al. Effective dose of dental CBCT—a meta analysis of published data and additional data for nine CBCT units. Dentomaxillofac Radiol. 2015; 44(1): 20140197.
16. 16. Scarfe WC, Farman AG. What is cone-beam CT and how does it work? Dent Clin N Am. 2008; 52(4): 707-30.
17. 17. Korkmaz Y, Kayıpmaz S, Senel F, Atasoy K, Gumrukcu Z. Does additional cone beam computed tomography decrease the risk of inferior alveolar nerve injury in high-risk cases undergoing third molar surgery? Does CBCT decrease the risk of IAN injury? Int J Oral Max Surg. 2017; 46(5): 628-35.
18. 18. Matzen LH, Berkhout E. Cone beam CT imaging of the mandibular third molar: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR). Dentomaxillofac Radiol. 2019; 48(5): 20190039.
19. 19. Van Acker JW, Martens LC, Aps JK. Cone-beam computed tomography in pediatric dentistry, a retrospective observational study. Clin Oral Investig. 2016; 20(5): 1003-10.
20. 20. Hidalgo‐Rivas JA, Theodorakou C, Carmichael F, Murray B, Payne M, Horner K. Use of cone beam CT in children and young people in three United Kingdom dental hospitals. Int J Paediatr Dent. 2014; 24(5): 336-48.
21. 21. Suzuki H, Fujimaki S, Chigono T, Yamamura M, Sakabe R, Sakabe J et al. Survey on the using limited area cone beam CT in pediatric dentistry. Japan J Pediatr Dent. 2006; 44(4): 609-16.
22. 22. Kamburoğlu K, Murat S, Kılıç C, Yüksel S, Avsever H, Farman A et al. Accuracy of CBCT images in the assessment of buccal marginal alveolar peri-implant defects: effect of field of view. Dentomaxillofac Radiol. 2014; 43(4): 20130332.
23. 23. Spin-Neto R, Wenzel A. Patient movement and motion artefacts in cone beam computed tomography of the dentomaxillofacial region: a systematic literature review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 121(4): 425-33.
24. 24. Donaldson K, O'Connor S, Heath N. Dental cone beam CT image quality possibly reduced by patient movement. Dentomaxillofac Radiol. 2013; 42(2): 91866873.
25. 25. Nardi C, Borri C, Regini F, Calistri L, Castellani A, Lorini C et al. Metal and motion artifacts by cone beam computed tomography (CBCT) in dental and maxillofacial study. Radiol Med. 2015; 120(7): 618-26.
26. 26. Spin-Neto R, Matzen LH, Schropp L, Gotfredsen E, Wenzel A. Factors affecting patient movement and re-exposure in cone beam computed tomography examination. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015; 119(5): 572-8.