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

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 fi...

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Autores principales: Jacobs, Reinhilde, Salmon, Benjamin, Codari, Marina, Hassan, Bassam, Bornstein, Michael M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952365/
https://www.ncbi.nlm.nih.gov/pubmed/29764458
http://dx.doi.org/10.1186/s12903-018-0523-5
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author Jacobs, Reinhilde
Salmon, Benjamin
Codari, Marina
Hassan, Bassam
Bornstein, Michael M.
author_facet Jacobs, Reinhilde
Salmon, Benjamin
Codari, Marina
Hassan, Bassam
Bornstein, Michael M.
author_sort Jacobs, Reinhilde
collection PubMed
description 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.
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spelling pubmed-59523652018-05-21 Cone beam computed tomography in implant dentistry: recommendations for clinical use Jacobs, Reinhilde Salmon, Benjamin Codari, Marina Hassan, Bassam Bornstein, Michael M. BMC Oral Health Research Article 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. BioMed Central 2018-05-15 /pmc/articles/PMC5952365/ /pubmed/29764458 http://dx.doi.org/10.1186/s12903-018-0523-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Jacobs, Reinhilde
Salmon, Benjamin
Codari, Marina
Hassan, Bassam
Bornstein, Michael M.
Cone beam computed tomography in implant dentistry: recommendations for clinical use
title 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_short Cone beam computed tomography in implant dentistry: recommendations for clinical use
title_sort cone beam computed tomography in implant dentistry: recommendations for clinical use
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952365/
https://www.ncbi.nlm.nih.gov/pubmed/29764458
http://dx.doi.org/10.1186/s12903-018-0523-5
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