Abstract
Objectives:Cone-Beam Computed Tomography (CBCT) produces vital information required for the accurate and prudent placement of dental implants. Lack of standardization between CBCT machines may result in unsafe patient exposure to harmful radiation; higher doses are not necessarily associated with improved image quality.Aim:The study aimed to assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning.Methods:Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using a CBCT (Carestream CS 9300). Cross-sectional slices of both image qualities were evaluated by five expert clinicians, for image quality for implant planning and objective bone measurements.Results:There were no significant differences in bone measurements taken on high or low dose images (p > 0.05). In qualitative image assessments, assessment and image quality for almost all observers were independent of each other. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low and high dose images.Conclusion:Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient intra-rater reliability for qualitative assessment; therefore dose reduction can be achieved without compromising diagnostic decision- making.
Highlights
Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient intrarater reliability for qualitative assessment; dose reduction can be achieved without compromising diagnostic decisionmaking
Cone Beam Computed Tomography (CBCT) is increasingly taking its place as a reliable radiological technique in the field of oral and maxillofacial radiology owing to the advantages it offers over traditional techniques such as panoramic radiography and medical Computed Tomography (CT)
Some authors have reported associations between dose reduction and increased image noise, which may degrade and reduce image quality [13, 14]. Using both objective and subjective measures, our results suggest that the expert observers were able to retrieve the information needed from the CBCT cuts independent of the image quality
Summary
Cone Beam Computed Tomography (CBCT) is increasingly taking its place as a reliable radiological technique in the field of oral and maxillofacial radiology owing to the advantages it offers over traditional techniques such as panoramic radiography and medical Computed Tomography (CT). CBCT offers a cost-effective method for the visualization of neurovascular and osseous structures during pre-surgical treatment planning; allowing the assessment of bone volume, trabecular structure and the presence of pathology [1, 2]. When planning the placement of dental implants, CBCT offers information that is crucial to the selection of final implant size and location by allowing the clinician to assess the amount, density and quality of bone, allowing optimal implant placement in avoidance of vital structures such as the mandibular canal and inferior alveolar nerve, the mandibular posterior lingual undercut, and the maxillary sinus [3]. There is a lack of published information on the appropriate methods to determine patient doses from CBCT equipment. The purpose of this study was to measure the impact of the reduction in the dose emitted by the CBCT on experienced clinicians’ ability to retrieve diagnostically useful information for pre-surgical treatment planning of dental implant placement
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