Role of Cone-Beam Computed Tomography in the Management of Periodontal Disease.

V Thomas Eshraghi,Mehrnaz Tahmasbi,Kyle A Malloy

doi:10.3390/dj7020057

V Thomas Eshraghi, Mehrnaz Tahmasbi + Show 1 more

Open Access

https://doi.org/10.3390/dj7020057

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Abstract

The goal of this paper was to review the current literature surrounding the use of cone beam computed tomography (CBCT) related to the diagnosis, prognostic determination, and treatment of periodontal diseases. A literature review was completed to identify peer-reviewed articles related to CBCT and periodontics. The results were filtered to pool only articles specific to CBCT and periodontal diagnosis, prognosis, and treatment/outcomes. The articles were reviewed and findings summarized. Author’s commentary on technological advances and additional potential uses of CBCT in the field of periodontics were included. There is evidence to suggest that CBCT imaging can be more accurate in diagnosing specific periodontal defects (intrabony and furcation defects), and therefore be helpful in the prognostic determination and treatment planning. However, at this time, CBCT cannot be recommended as the standard of care. It is up to the individual clinician to use one’s own judgment as to when the additional information provided by CBCT may be beneficial, while applying the As Low As Reasonably Achievable (ALARA) principle. With continued technological advances in CBCT imaging (higher resolution, reduced imaging artifacts, lower exposure, etc.) the author’s believe that CBCT usage will become more prominent in diagnosis and treatment of periodontal diseases.

Highlights

Periodontal diseases have high prevalence in both developed and developing nations affecting upwards of 20 to 50% of global populations [1]
Established risk factors associated with periodontal disease include diabetes, smoking, genetic pre-disposition, stress, medications, and other factors
Controlled periodontal diseases are characterized by attachment loss, bone loss and in the most severe progression, tooth loss

Summary

Introduction

Periodontal diseases have high prevalence in both developed and developing nations affecting upwards of 20 to 50% of global populations [1]. Recent evidence has shown strong association of periodontal disease with cardiovascular disease, diabetes, and adverse pregnancy outcomes [2]. The first step in disease management is proper diagnosis. Diagnosing periodontal defects classically has relied upon interpretation of two-dimensional (2D). J. 2019, 7, 57 defects in the straight buccal, lingual, as well as furcations of affected teeth can be difficult or impossible to properly diagnose requiring further surgical extension for diagnosis and treatment [11]. Cone beam computed tomography (CBCT) imaging is a powerful tool allowing for the diagnosis of three-dimensional (3D) structures and is well documented as a tool for accurate quantification and locating anatomic structures. The aim of this paper was two-fold: (1) to review current evidence-based literature and determine the efficacy of CBCT for management of periodontal disease and (2) to discuss current limitations and possible future applications

Current Evidence of CBCT and Periodontal Therapies

Findings

Technological Advances and Potential Uses of CBCT and Periodontal Therapies