Trends in maxillofacial cone-beam computed tomography usage

Abstract

Cone-beam computed tomography (CBCT) is making inroads into dental practice worldwide, both in terms of adding the third dimension to diagnosis, and also in terms of enabling image-guided treatment strategies. This article reports trends in the early referral pattern of patients to a CBCT facility in the United States. With institutional review board approval, a retrospective study was made of sequential CBCT radiographic reports made by a specialist oral and maxillofacial radiology service from May 2004 through January 2006 (n = 329). Demographic and referral data were extracted from the reports. Descriptive statistics identified referral patterns, trends, and indications for CBCT. Comparisons were made with the Rogers' Product Innovation Adoption curve. The mean age of referred patients was 45 ± 21 years, and there was a predominance of women (62%). Oral and maxillofacial surgeons (51%) and periodontology specialists (17%) made most patient referrals. The listed reasons for CBCT referrals were dental implant planning (40%), suspected surgical pathology (24%), and temporomandibular joint analysis (16%). Other uses included planning extraction of impacted teeth and orthodontic assessment. Over the period of the study, the numbers of pathology diagnosis cases remained relatively constant, while adoption of CBCT for dental implant planning followed closely the first three stages of the Rogers' Product Innovation Adoption curve. Alongside this increased CBCT adoption for dental implant planning, there was an associated increased demand for use of DICOM image sets for laser modeling and provision of surgical guides. Diagnosis will probably remain a constant source of referral for CBCT examination by oral and maxillofacial radiologists. Nevertheless, more specialized applications such as laser-guided model fabrication and image-guided surgery are expanding indications for CBCT referrals by dentists and also expanding the horizons of clinical dental practice.