Cone-Beam Computed Tomography Education and Exposure in Oral and Maxillofacial Surgery Training Programs in the United States

Current status of cone-beam computed tomography teaching in Brazilian undergraduate endodontic programs - A web-based survey

PURPOSES

This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs.

METHODS

One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic.

RESULTS

Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images.

CONCLUSIONS

The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic.

Assessment of the knowledge of canalis sinuosus amongst dentists and dental students: An online-based cross-sectional study

INTRODUCTION

Canalis sinuosus (CS) is a neurovascular canal that corresponds to a small branch of the infraorbital canal. This study aimed at assessing the knowledge and detection performance of CS amongst dentists and dental students.

MATERIALS AND METHODS

Four-hundred and five dentists and dental students answered a questionnaire with three parts: 1. Socio-demographical; 2. Clinical cases with cone- beam computed tomography (CBCT) sections showing CS and 3. Previous knowledge about CS. The chi-squared test and Spearman's correlation test were used to compare results as appropriate. p-values below .05 were considered statistically significant.

RESULTS

Most participants did not identify CS in any CBCT. There was an association between the number of correct answers and dental specialties. Most individuals had not learned about CS previously. There was an association between past knowledge of CS and gender, highest academic degree, working environment, dental specialty and number of correct answers but not with age or experience in Dentistry.

CONCLUSION

This study suggests that most dentists are not aware about CS and do not know how to diagnose it. Previous knowledge about CS positively influenced its identification in CBCT.

Current trends in the adoption and education of cone beam computed tomography and panoramic radiography machines across Australia

OBJECTIVES

This is a follow-up study to assess growth in the number of cone beam computed tomography (CBCT) and panoramic radiography (PR) machines in Australia. It is also the first study to evaluate the current status of both CBCT and PR education in Australia.

METHODS

CBCT and PR machine numbers were obtained from the radiation regulators across Australia. Australian dental schools were surveyed via email. The number of machines relative to population size and the number of dentists were calculated.

RESULTS

In 2020, there were 706 CBCT machines and 3,059 PR machines, representing a 204.3% increase in the number of CBCT machines and an 82.0% increase in the number of PR machines over six years. Majority of Australian dental schools owned PR and CBCT machines. Most taught PR acquisition and interpretation, however only one-third taught CBCT image acquisition and interpretation to predoctoral students.

CONCLUSIONS

CBCT machine numbers increased by nearly three-fold while PR machines only increased by 1.6 times over a six-year period relative to population size and number of dentists. Only very few Australian dental schools provide CBCT education to predoctoral students, raising concern as to whether graduates are adequately trained upon program completion.

CBCT in Advanced Dental Education: A Survey of U.S. Postdoctoral Periodontics Programs

Historically, predoctoral and advanced dental education programs used two-dimensional panoramic and periapical radiographs for implant planning. Three-dimensional (3D) Cone Beam Computed Tomography (CBCT) imaging has improved visualization of anatomic structures that can positively influence implant planning and surgical implant placement. The aim of this study was to assess how U.S. postdoctoral periodontics programs have incorporated CBCT technology into their curricula. A ten-question survey was sent to all 57 U.S. postdoctoral periodontics programs in November-December 2018. Thirty-seven responses were received, for a 65% response rate. All participating programs reported providing residents access to CBCT machines, and most of their residents received some training in the acquisition and interpretation of CBCT images. Nearly all (95%) participating programs provided training to apply implant planning software. Among the participating programs, 14% reported using a surgical guide fabricated with a CBCT scan 76-100% of the time, and 60% reported obtaining a CBCT scan for implant cases 76-100% of the time. These results suggest that, while residents are receiving training in CBCT and implant planning, it is not used often. There may be merit in adopting the American Academy of Oral and Maxillofacial Radiology's recommendation to use 3D imaging for all implant planning, with CBCT as the imaging modality of choice.

Accuracy of Cone-beam Computed Tomographic Image Interpretation by Endodontists and Endodontic Residents

INTRODUCTION

Limited field cone-beam computed tomography (CBCT) imaging has become a modality frequently used by endodontists to evaluate the teeth and surrounding tissues of their patients. Accurate image interpretation is vital to obtain needed treatment information as well as to discern coincidental findings that could be present. The goal of this study was to determine the accuracy of CBCT volume interpretation when performed by endodontists and endodontic residents.

METHODS

Eighteen deidentified limited field CBCT scans were obtained and evaluated by an oral and maxillofacial radiologist and an endodontist experienced in reading CBCT images. Their collective findings were combined as the "gold standard" of interpretation for this investigation. Using standard CBCT software, 4 practicing endodontists and 5 second-year endodontic residents evaluated each scan and recorded any notable findings and whether or not each scan warranted referral to a radiology specialist. Their interpretations were then compared with the gold standard to determine accuracy and any significant differences among the groups.

RESULTS

The overall accuracy was 58.3% for endodontists and 64.3% for residents. Paired t tests showed no statistically significant differences in accuracy between the 2 groups for findings in teeth or in bone, but residents were significantly better for maxillary sinus findings. Endodontists agreed with the gold standard 38.9% of the time and residents 49.8% of the time on necessity of referral. The Cohen kappa coefficient showed moderate agreement between the groups.

CONCLUSIONS

Endodontists and residents had similar accuracy in CBCT scan evaluation. More training and experience are warranted for both groups in order to maximize image assessment accuracy.

Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography-influence of professional training

Background

A comparison of panoramic radiography (PAN) alone and PAN together with small field of view cone beam computed tomography (sFOV-CBCT) for diagnosis of symptomatic pathologies of the maxillary sinus was carried out by clinicians of different experience.

Methods

Corresponding radiographic images (PAN/sFOV-CBCT) of 28 patients with symptomatic maxillary sinus pathologies were chosen and analyzed by two general practitioners (GP), two junior maxillofacial surgeons (MS1), and three senior maxillofacial surgeons (MS2) via questionnaire.

Results

Visibility of maxillary pathologies in PAN was significantly different between the groups (GP 39%, MS1 48%, MS2 61%; p < 0.05). The number of incidental findings varied within examiner groups in PAN with a significant increase in MS2 (p = 0.027). The majority of examiners rated an additional sFOV-CBCT as “reasonable”/“required” with a significant influence of the examining groups (GP 98.2%, MS1 94.6%, MS2 80.9%; p = 0.008). In 58% of cases, an additional sFOV-CBCT was seen as “affecting therapy” with significant differences between the groups (GP 68%, MS1 50%, MS2 55%; p < 0.001).

Conclusions

PAN alone is not sufficient for the evaluation of pathologies of the maxillary sinus. But, depending on the examiners’ clinical experience, it remains a useful diagnostic tool. Along with the observers’ training, significant benefits of an additional sFOV-CBCT for evaluation of symptomatic maxillary sinus pathologies were detected.

Presurgical evaluation of bony implant sites using panoramic radiography and cone beam computed tomography-influence of medical education

OBJECTIVES

The aim of this study was to compare the subjective quality rating of panoramic radiography (PAN) and CBCT in the planning of dental implant procedures by clinicians with different educational backgrounds.

METHODS

Radiographic images (PAN and CBCT) of 42 patients were examined as follows: the maxillary (MX) anterior region of patients, the MX posterior region of 16 patients and the mandibular (MD) posterior region of 16 patients. These sites were used for planning of dental implant insertion. Data sets were analyzed by examiners with different training backgrounds: three general practitioners (GP), three oral surgeons (OS) and three maxillofacial surgeons (MS). A standardized questionnaire in a standardized setting was answered by participants.

RESULTS

The majority of participants rated an additional CBCT as "required" (14.0%) or "reasonable" (56.1%). These ratings depended strongly on the area of interest (MX anterior region: 31.1 and 58.9%; MX posterior region: 14.6 and 62.5%; and MD posterior region: 2.8% and 47.9%). MS classified CBCT as required more often than GP and OS (23.8 vs 10.3 and 7.9%; p < 0.001). With the additional information of CBCT, "therapy affecting" ratings were stated high in all groups.

CONCLUSIONS

Especially in the anterior and posterior MX, significant subjective benefits for an additional CBCT were seen for planning of dental implant procedures. Participants with fundamental medical education asked for CBCT more often. The results indicate that an improved education in three-dimensional dental radiology is necessary.