Cone beam computed tomography in implant dentistry: recommendations for clinical use

Abstract Background In implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing sinc...

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Main Authors: Reinhilde Jacobs, Benjamin Salmon, Marina Codari, Bassam Hassan, Michael M. Bornstein
Format: Article
Language:English
Published: BMC 2018-05-01
Series:BMC Oral Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12903-018-0523-5
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spelling doaj-65b9ab22288a4ba29d41b4f37bbff6552020-11-25T00:12:12ZengBMCBMC Oral Health1472-68312018-05-0118111610.1186/s12903-018-0523-5Cone beam computed tomography in implant dentistry: recommendations for clinical useReinhilde Jacobs0Benjamin Salmon1Marina Codari2Bassam Hassan3Michael M. Bornstein4OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenEA2496, Orofacial Pathologies, Imaging and Biotherapies Lab, Dental School Paris Descartes University, Sorbonne Paris CitéUnit of Radiology, IRCCS Policlinico San DonatoDepartment of Oral Function and Restorative Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVEOMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of LeuvenAbstract Background In implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing since the first dental CBCT system appeared two decades ago. More than 85 different CBCT devices are currently available and this exponential growth has created a gap between scientific evidence and existing CBCT machines. Indeed, research for one CBCT machine cannot be automatically applied to other systems. Methods Supported by a narrative review, recommendations for justified and optimized CBCT imaging in oral implant dentistry are provided. Results The huge range in dose and diagnostic image quality requires further optimization and justification prior to clinical use. Yet, indications in implant dentistry may go beyond diagnostics. In fact, the inherent 3D datasets may further allow surgical planning and transfer to surgery via 3D printing or navigation. Nonetheless, effective radiation doses of distinct dental CBCT machines and protocols may largely vary with equivalent doses ranging between 2 to 200 panoramic radiographs, even for similar indications. Likewise, such variation is also noticed for diagnostic image quality, which reveals a massive variability amongst CBCT technologies and exposure protocols. For anatomical model making, the so-called segmentation accuracy may reach up to 200 μm, but considering wide variations in machine performance, larger inaccuracies may apply. This also holds true for linear measures, with accuracies of 200 μm being feasible, while sometimes fivefold inaccuracy levels may be reached. Diagnostic image quality may also be dramatically hampered by patient factors, such as motion and metal artefacts. Apart from radiodiagnostic possibilities, CBCT may offer a huge therapeutic potential, related to surgical guides and further prosthetic rehabilitation. Those additional opportunities may surely clarify part of the success of using CBCT for presurgical implant planning and its transfer to surgery and prosthetic solutions. Conclusions Hence, dental CBCT could be justified for presurgical diagnosis, preoperative planning and peroperative transfer for oral implant rehabilitation, whilst striving for optimisation of CBCT based machine-dependent, patient-specific and indication-oriented variables.http://link.springer.com/article/10.1186/s12903-018-0523-5Cone beam computed tomographyDental implantsPresurgical planningGuidelinesRadiation doseVirtual patient
collection DOAJ
language English
format Article
sources DOAJ
author Reinhilde Jacobs
Benjamin Salmon
Marina Codari
Bassam Hassan
Michael M. Bornstein
spellingShingle Reinhilde Jacobs
Benjamin Salmon
Marina Codari
Bassam Hassan
Michael M. Bornstein
Cone beam computed tomography in implant dentistry: recommendations for clinical use
BMC Oral Health
Cone beam computed tomography
Dental implants
Presurgical planning
Guidelines
Radiation dose
Virtual patient
author_facet Reinhilde Jacobs
Benjamin Salmon
Marina Codari
Bassam Hassan
Michael M. Bornstein
author_sort Reinhilde Jacobs
title Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_short Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_full Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_fullStr Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_full_unstemmed Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_sort cone beam computed tomography in implant dentistry: recommendations for clinical use
publisher BMC
series BMC Oral Health
issn 1472-6831
publishDate 2018-05-01
description Abstract Background In implant dentistry, three-dimensional (3D) imaging can be realised by dental cone beam computed tomography (CBCT), offering volumetric data on jaw bones and teeth with relatively low radiation doses and costs. The latter may explain why the market has been steadily growing since the first dental CBCT system appeared two decades ago. More than 85 different CBCT devices are currently available and this exponential growth has created a gap between scientific evidence and existing CBCT machines. Indeed, research for one CBCT machine cannot be automatically applied to other systems. Methods Supported by a narrative review, recommendations for justified and optimized CBCT imaging in oral implant dentistry are provided. Results The huge range in dose and diagnostic image quality requires further optimization and justification prior to clinical use. Yet, indications in implant dentistry may go beyond diagnostics. In fact, the inherent 3D datasets may further allow surgical planning and transfer to surgery via 3D printing or navigation. Nonetheless, effective radiation doses of distinct dental CBCT machines and protocols may largely vary with equivalent doses ranging between 2 to 200 panoramic radiographs, even for similar indications. Likewise, such variation is also noticed for diagnostic image quality, which reveals a massive variability amongst CBCT technologies and exposure protocols. For anatomical model making, the so-called segmentation accuracy may reach up to 200 μm, but considering wide variations in machine performance, larger inaccuracies may apply. This also holds true for linear measures, with accuracies of 200 μm being feasible, while sometimes fivefold inaccuracy levels may be reached. Diagnostic image quality may also be dramatically hampered by patient factors, such as motion and metal artefacts. Apart from radiodiagnostic possibilities, CBCT may offer a huge therapeutic potential, related to surgical guides and further prosthetic rehabilitation. Those additional opportunities may surely clarify part of the success of using CBCT for presurgical implant planning and its transfer to surgery and prosthetic solutions. Conclusions Hence, dental CBCT could be justified for presurgical diagnosis, preoperative planning and peroperative transfer for oral implant rehabilitation, whilst striving for optimisation of CBCT based machine-dependent, patient-specific and indication-oriented variables.
topic Cone beam computed tomography
Dental implants
Presurgical planning
Guidelines
Radiation dose
Virtual patient
url http://link.springer.com/article/10.1186/s12903-018-0523-5
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