Patterns of Cone-Beam Computed Tomography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center.

Silvina Friedlander-Barenboim,Avraham Zini,Wafi Hamed,Tamar Finkelstein,Galit Almoznino,Itzhak Abramovitz,Harry Chweidan,Noam Yarom

doi:10.3390/healthcare9081042

Abstract

The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9–86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.

Highlights

Along with clinical examination, radiological imaging is essential for a complete diagnosis in dental medicine
According to most prevailing guidelines, three-dimensional cone-beam computed tomography (CBCT) imaging is recommended for patients for whom the diagnosis would otherwise remain uncertain or the treatment plan unclear [5,6,7]
Our research was done to improve our understanding of the contribution and the limitations of CBCT imaging modality in the diagnosis and treatment planning by different oral and maxillofacial specialties

Summary

Introduction

Radiological imaging is essential for a complete diagnosis in dental medicine. Analysis of radiographic images is often essential in confirming or negating clinical findings or diagnoses. These radiographs contain essential information regarding the teeth, jaws, and more anatomical structures such as the maxillary sinuses, temporomandibular joints (TMJ), and even the nasal cavity [1,2]. Panoramic and periapical radiographs have some limitations, such as being limited to two dimensional imaging, distortion, and blurring [3]. The broad coverage of the panoramic and periapical radiographs will still be insufficient to obtain an accurate diagnosis or enable the dentist to perform a treatment plan [4]

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