CONE BEAM COMPUTED TOMOGRAPHY: BASICS AND APPLICATIONS IN DENTISTRY

Abstract

The introduction of cone beam computed tomography (CBCT) devices, changed the way oral and maxillofacial radiology is practiced. CBCT was embraced into the dental settings very rapidly due to its compact size, low cost, low ionizing radiation exposure when compared to medical computed tomography. Alike medical CT, 3 dimensional evaluation of the maxillofacial region with minimal distortion is offered by the CBCT. This article provides an overview of basics of CBCT technology and reviews the specific application of CBCT technology to oral and maxillofacial region with few illustrations. 

Keywords

• Cone beam computed tomography,dentistry; radiography; x-ray; oral and maxillofacial imaging

References

1. Goldman LW. Principles of ct and ct technology. J Nucl Med Technol 2007;35(3):115-128; quiz 129-130.
2. Arai Y, Tammisalo E, Iwai K, Hashimoto K, Shinoda K. Development of a compact computed tomographic apparatus for dental use. Dentomaxillofac Radiol 1999;28(4):245-248.
3. Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA. A new volumetric ct machine for dental imaging based on the cone-beam technique: Preliminary results. Eur Radiol 1998;8(9):1558-1564.
4. Feldkamp LA, Davis LC, Kress JW. Practical cone-beam algorithm. J Opt Soc Am 1984;1(6):612-619.
5. Danforth RA, Miles DA. Cone beam volume imaging (cbvi): 3d applications for dentistry. Irish Dent 2007;10(9):14-18.
6. Howerton WB, Jr., Mora MA. Advancements in digital imaging: What is new and on the horizon? J Am Dent Assoc 2008;139 Suppl:20S-24S.
7. Miracle AC, Mukherji SK. Conebeam ct of the head and neck, part 2: Clinical applications. AJNR Am J Neuroradiol 2009;30(7):1285-1292.
8. European Academy of Dental and Maxillofacial Radiol¬ogy. Basic principles for use of dental cone beam CT. http://eadmfr.eu/sites/default/files/donwloads/Basic_Principles_for_Use_of_Dental_Cone_Beam_CT.pdf Accessed: February 20, 2017.

9. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006;72(1):75-80.
10. White SC, Pharoah M. Oral radiology principles and interpretation. St. Louis: Mosby Elsevier, 2014, 199-212.
11. Gutierrez D, Monnin P, Valley JF, Verdun FR. A strategy to qualify the performance of radiographic monitors. Radiat Prot Dosimetry 2005;114(1-3):192-197.
12. Palomo L, Palomo JM. Cone beam ct for diagnosis and treatment planning in trauma cases. Dent Clin North Am 2009;53(4):717-727, vi-vii.
13. Razavi T, Palmer RM, Davies J, Wilson R, Palmer PJ. Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography. Clin Oral Implants Res 2010;21(7):718-725.
14. Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: Newtom cone beam ct and orthophos plus ds panoramic unit. Dentomaxillofac Radiol 2003;32(4):229-234.
15. Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 cbct devices for oral and maxillofacial radiology: Cb mercuray, newtom 3g and i-cat. Dentomaxillofac Radiol 2006;35(4):219-226.
16. Ludlow JB, Davies-Ludlow LL, Mol A. Dosimetry of recently introduced cbct units for oral and maxillofacial radiology. Beijing, China: Proceedings of the 16th International Congress of Dentomaxillofacial Radiology, 26-30 June 2007, 97.
17. Mah JK, Danforth RA, Bumann A, Hatcher D. Radiation absorbed in maxillofacial imaging with a new dental computed tomography device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96(4):508-513.
18. Schulze D, Heiland M, Thurmann H, Adam G. Radiation exposure during midfacial imaging using 4- and 16-slice computed tomography, cone beam computed tomography systems and conventional radiography. Dentomaxillofac Radiol 2004;33(2):83-86.
19. Scarfe WC, Farman AG. What is cone-beam ct and how does it work? Dent Clin North Am 2008;52(4):707-730, v.
20. Cohnen M, Kemper J, Mobes O, Pawelzik J, Modder U. Radiation dose in dental radiology. Eur Radiol 2002;12(3):634-637.
21. Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U, Schoemer E. Artefacts in cbct: A review. Dentomaxillofac Radiol 2011;40(5):265-273.
22. Endo M, Tsunoo T, Nakamori N, Yoshida K. Effect of scattered radiation on image noise in cone beam ct. Med Phys 2001;28(4):469-474.
23. Farman AG. Guest editorial--self-referral: An ethical concern with respect to multidimensional imaging in dentistry? J Appl Oral Sci 2009;17(5):
24. Wiegert J, Bertram M, Schafer D, et al. Soft tissue contrast resolution within the head of human cadaver by means of flat detector based cone-beam ct. Proc SPIE 2004;5368(6):330-337.
25. Almog DM, LaMar J, LaMar FR, LaMar F. Cone beam computerized tomography-based dental imaging for implant planning and surgical guidance, part 1: Single implant in the mandibular molar region. J Oral Implantol 2006;32(2):77-81.
26. Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC, American Academy of O, Maxillofacial R. Position statement of the american academy of oral and maxillofacial radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;113(6):817-826.
27. Yajima A, Otonari-Yamamoto M, Sano T, Hayakawa Y, Otonari T, Tanabe K, Wakoh M, Mizuta S, Yonezu H, Nakagawa K, Yajima Y. Cone-beam ct (cb throne) applied to dentomaxillofacial region. Bull Tokyo Dent Coll 2006;47(3):133-141.
28. Tischler M. In-office cone beam computerized tomography: Technology review and clinical examples. Dent Today 2008;27(6):102, 104, 106.
29. Nickenig HJ, Eitner S. Reliability of implant placement after virtual planning of implant positions using cone beam ct data and surgical (guide) templates. J Craniomaxillofac Surg 2007;35(4-5):207-211.
30. Cevidanes LH, Bailey LJ, Tucker GR, Jr., Styner MA, Mol A, Phillips CL, Proffit WR, Turvey T. Superimposition of 3d cone-beam ct models of orthognathic surgery patients. Dentomaxillofac Radiol 2005;34(6):369-375.
31. Heiland M, Schulze D, Rother U, Schmelzle R. Postoperative imaging of zygomaticomaxillary complex fractures using digital volume tomography. J Oral Maxillofac Surg 2004;62(11):1387-1391.
32. Pohlenz P, Blessmann M, Blake F, Heinrich S, Schmelzle R, Heiland M. Clinical indications and perspectives for intraoperative cone-beam computed tomography in oral and maxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(3):412-417.
33. Pohlenz P, Blessmann M, Blake F, Gbara A, Schmelzle R, Heiland M. Major mandibular surgical procedures as an indication for intraoperative imaging. J Oral Maxillofac Surg 2008;66(2):324-329.
34. Fullmer JM, Scarfe WC, Kushner GM, Alpert B, Farman AG. Cone beam computed tomographic findings in refractory chronic suppurative osteomyelitis of the mandible. Br J Oral Maxillofac Surg 2007;45(5):364-371.
35. Tetradis S, Anstey P, Graff-Radford S. Cone beam computed tomography in the diagnosis of dental disease. J Calif Dent Assoc 2010;38(1):27-32.
36. Liu DG, Zhang WL, Zhang ZY, Wu YT, Ma XC. Localization of impacted maxillary canines and observation of adjacent incisor resorption with cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105(1):91-98
37. Pawelzik J, Cohnen M, Willers R, Becker J. A comparison of conventional panoramic radiographs with volumetric computed tomography images in the preoperative assessment of impacted mandibular third molars. J Oral Maxillofac Surg 2002;60(9):979-984.
38. Hamada Y, Kondoh T, Noguchi K, Iino M, Isono H, Ishii H, Mishima A, Kobayashi K, Seto K. Application of limited cone beam computed tomography to clinical assessment of alveolar bone grafting: A preliminary report. Cleft Palate Craniofac J 2005;42(2):128-137.
39. Kumar V, Pass B, Guttenberg SA, Ludlow J, Emery RW, Tyndall DA, Padilla RJ. Bisphosphonate-related osteonecrosis of the jaws: A report of three cases demonstrating variability in outcomes and morbidity. J Am Dent Assoc 2007;138(5):602-609.
40. American Dental Association Council on Scientific A. The use of cone-beam computed tomography in dentistry: An advisory statement from the american dental association council on scientific affairs. J Am Dent Assoc 2012;143(8):899-902.
41. Ogawa T, Enciso R, Shintaku WH, Clark GT. Evaluation of cross-section airway configuration of obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(1):102-108.
42. Aboudara CA, Hatcher D, Nielsen IL, Miller A. A three-dimensional evaluation of the upper airway in adolescents. Orthod Craniofac Res 2003;6 Suppl 1:173-175.
43. Harrell WE Jr. Three-dimensional diagnosis and treatment planning: The use of 3d facial imaging and 3d cone beam CT in orthodontics and dentistry. Australasian Dent Pract 2007;18(4):102-113.
44. Kapila S, Conley RS, Harrell WE, Jr. The current status of cone beam computed tomography imaging in orthodontics. Dentomaxillofac Radiol 2011;40(1):24-34.
45. Peck JL, Sameshima GT, Miller A, Worth P, Hatcher DC. Mesiodistal root angulation using panoramic and cone beam CT. Angle Orthod 2007;77(2):206-213.
46. Kim SH, Choi YS, Hwang EH, Chung KR, Kook YA, Nelson G. Surgical positioning of orthodontic mini-implants with guides fabricated on models replicated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2007;131(4 Suppl):S82-89.
47. Kim SH, Kang JM, Choi B, Nelson G. Clinical application of a stereolithographic surgical guide for simple positioning of orthodontic mini-implants. World J Orthod 2008;9(4):371-382.
48. Tsiklakis K, Syriopoulos K, Stamatakis HC. Radiographic examination of the temporomandibular joint using cone beam computed tomography. Dentomaxillofac Radiol 2004;33(3):196-201.
49. Honda K, Matumoto K, Kashima M, Takano Y, Kawashima S, Arai Y. Single air contrast arthrography for temporomandibular joint disorder using limited cone beam computed tomography for dental use. Dentomaxillofac Radiol 2004;33(4):271-273.
50. Kijima N, Honda K, Kuroki Y, Sakabe J, Ejima K, Nakajima I. Relationship between patient characteristics, mandibular head morphology and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints. Dentomaxillofac Radiol 2007;36(5):277-281.
51. Honda K, Larheim TA, Johannessen S, Arai Y, Shinoda K, Westesson PL. Ortho cubic super-high resolution computed tomography: A new radiographic technique with application to the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91(2):239-243.
52. Sakabe R, Sakabe J, Kuroki Y, Nakajima I, Kijima N, Honda K. Evaluation of temporomandibular disorders in children using limited cone-beam computed tomography: A case report. J Clin Pediatr Dent 2006;31(1):14-16.
53. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod 2007;33(9):1121-1132.
54. Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura H. Effectiveness of dental computed tomography in diagnostic imaging of periradicular lesion of each root of a multirooted tooth: A case report. J Endod 2006;32(6):583-587.
55. Tyndall DA, Rathore S. Cone-beam ct diagnostic applications: Caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am 2008;52(4):825-841, vii.
56. Ozer SY. Detection of vertical root fractures of different thicknesses in endodontically enlarged teeth by cone beam computed tomography versus digital radiography. J Endod 2010;36(7):1245-1249.
57. Nagaraja S, Sreenivasa Murthy BV. Ct evaluation of canal preparation using rotary and hand ni-ti instruments: An in vitro study. J Conserv Dent 2010;13(1):16-22.
58. Siraci E, Cem Gungor H, Taner B, Cehreli ZC. Buccal and palatal talon cusps with pulp extensions on a supernumerary primary tooth. Dentomaxillofac Radiol 2006;35(6):469-472.
59. Vandenberghe B, Jacobs R, Yang J. Diagnostic validity (or acuity) of 2d ccd versus 3d cbct-images for assessing periodontal breakdown. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104(3):395-401.
60. Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol 2006;77(7):1261-1266.
61. Ito K, Yoshinuma N, Goke E, Arai Y, Shinoda K. Clinical application of a new compact computed tomography system for evaluating the outcome of regenerative therapy: A case report. J Periodontol 2001;72(5):696-702.
62. Yang F, Jacobs R, Willems G. Dental age estimation through volume matching of teeth imaged by cone-beam ct. Forensic Sci Int 2006;159 Suppl 1:S78-83.
63. Abou-ElFetouh A, Barakat A, Abdel-Ghany K. Computer-guided rapid-prototyped templates for segmental mandibular osteotomies: A preliminary report. Int J Med Robot 2011;7(2):187-192.
64. Jayaratne YS, Zwahlen RA, Lo J, Tam SC, Cheung LK. Computer-aided maxillofacial surgery: An update. Surg Innov 2010;17(3):217-225.
65. D'Urso PS, Barker TM, Earwaker WJ, Bruce LJ, Atkinson RL, Lanigan MW, Arvier JF, Effeney DJ. Stereolithographic biomodelling in cranio-maxillofacial surgery: A prospective trial. J Craniomaxillofac Surg 1999;27(1):30-37.