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Popkowski A, Rhodes SC, Hatton JF. Proposed Diagnostic Reference Levels in the Missouri/Southern Illinois Region Associated with Cone-beam Computed Tomography Use in Endodontics. J Endod 2024; 50:966-975. [PMID: 38382736 DOI: 10.1016/j.joen.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Diagnostic reference levels (DRLs) are intended to improve patient safety and ensure that patient ionizing radiation doses are as low as reasonably achievable. The purpose of this dosimetry study was to establish regional DRL levels for cone-beam computed tomography (CBCT) imaging for specialty endodontics. Another aim was to compare phantom-measured ionizing radiation dose index 1 (DI1) index doses to the manufacturer-provided dose area product (DAP) radiation output values for each of the CBCT machines studied, to ascertain their degree of correlation. DAP refers to the dose area product, a measure of radiation dose monitoring which represents the dose within the beam times the area within the beam at that position. METHODS A thimble ionization chamber and polymethyl methacrylate phantom were used to obtain DI1 values using the SEDENTEXTCT method from 21 different CBCT units. DRLs were calculated based on the 75th percentile (third quartile) of the median output values. RESULTS The proposed DRL from the CBCT units surveyed has a DAP value of 838 mGy cm2 and a DI1 value of 3.924 mGy. DAP versus DI1 values of 500.6 mGy cm2 versus 2.006 mGy, and 838 mGy cm2 versus 3.906 mGy represented the third quartile of the median values for the 4-cm × 4-cm and 5-cm × 5-cm field of views (FOVs), respectively. CONCLUSIONS The DI1 and DAP values strongly correlated when 3 outlier CBCT machines (J Morita Veraview X800) using a novel 360° (full rotation) acquisition mode were excluded. The importance of selectable exposure parameters as directly related to ionizing radiation output is illustrated among the CBCT units surveyed. Although the actual FOV that is selected is ultimately dictated by the specific clinical requirements, a 4-cm × 4-cm FOV is recommended for specialist endodontics practice, whenever clinically practical, based on the decreased ionizing radiation output, as compared to that from a 5-cm × 5-cm FOV.
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Affiliation(s)
- Arthur Popkowski
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
| | - S Craig Rhodes
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri.
| | - John F Hatton
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, Saint Louis, Missouri
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Klingler S, Biel P, Tschanz M, Schulze R. CBCTs in a Swiss university dental clinic: a retrospective evaluation over 5 years with emphasis on radiation protection criteria. Clin Oral Investig 2023; 27:5627-5636. [PMID: 37522991 PMCID: PMC10492752 DOI: 10.1007/s00784-023-05184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES To retrospectively evaluate all cone-beam computed tomography (CBCT) scans acquired from 2017 to 2022 in a Swiss university dental clinic with particular emphasis on radiation protection aspects. MATERIAL AND METHODS Radiological databases at the dental clinic of the University of Bern, Switzerland, were explored using a self-developed search algorithm. Data of all acquired CBCT from 01.01.2017 to 27.06.2022 were screened. Exposure parameters (exposure time, exposure angle, milliampere (mA), kilovoltage (kV), field of view (FOV) size), dose area product (DAP), age, and sex of the patient were recorded anonymously. The collected data were analyzed mainly descriptively. Correlations measured the statistical relationships between the variables. RESULTS A total of 10,348 CBCT datasets were analyzed. Patient age ranged from 5 to 96 years (mean: 49.4 years, SD: 21.6 years). The number of CBCTs in patients under 25 years was around 20% each year. In total, 10,313 (99.7%) CBCTs were acquired in small to medium FOV (FOV up to 10 cm of height), and 35 (0.3%) in large FOV (height > 10 cm). DAPs of small FOVs were 518.3 ± 233.2 mGycm2 (mean ± SD), of medium FOV 1233 ± 502.2 mGycm2, and of large FOV 2189 ± 368.7 mGycm2. DAP (ρ = 0.4048, p < 0.0001) and kV (ρ = 0.0210, p = 0.0327) correlated positively with age. Reduced scan angle correlated with young age (rpb 0.2729, p < 0.001). mA did not correlate with age (p = 0.3685). CONCLUSIONS This study demonstrates that certain well-known radiation protection aspects as the reduction of FOV, mA, kV, and scan angle were only partly considered. CLINICAL RELEVANCE Known radiation protection aspects, especially in young patients, should be fully applied in regular clinical practice.
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Affiliation(s)
- Samuel Klingler
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Philippe Biel
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Moses Tschanz
- Information Technology (IT) Group, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Ralf Schulze
- Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Division of Oral Diagnostic Sciences, Department of Oral Surgery and Stomatology and Oral Diagnostics, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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Cederhag J, Iskanderani D, Alstergren P, Shi XQ, Hellén-Halme K. Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT. Acta Odontol Scand 2023:1-7. [PMID: 36748228 DOI: 10.1080/00016357.2023.2170462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Optimization of radiographic examinations is essential for radiation protection. The objective of the study was to investigate the clinical applicability of a low-dose CBCT protocol as compared to the default for pre-surgical evaluation of mandibular third molars. MATERIAL & METHODS Forty-eight patients (62 teeth) referred for pre-surgical mandibular third molar investigation were recruited after justification for CBCT. Two CBCT scans of each site were made using a default protocol and a low-dose protocol (Veraviewepocs 3D F40, J Morita Corp, Kyoto, Japan). The low-dose protocol had the same tube potential (90 kV) and exposure time (9.4 s) as the default, but with reduced tube current, from 5 mA to 2 mA. Four observers evaluated the visibility of five relevant anatomical variables. Image quality was ranked on a 3-point scale as diagnostically acceptable, doubtful, or unacceptable. The Wilcoxon signed-rank test compared differences between the two protocols. The significance level was set at p ≤ .05. RESULTS No significant differences were found between the two protocols for any observer regarding the visibility of the relationship and proximity between the roots and the mandibular canal; root morphology; and possible root resorption of the second molar. The periodontal ligament differed significantly in visibility between the two protocols (p ≤ .05). CONCLUSIONS This study indicates that a low-dose CBCT protocol with a 60% reduction of the tube current provides, in most cases, acceptable image quality for pre-surgical assessment of mandibular third molars. Optimization of CBCT protocols should be a priority according to recommended guidelines.
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Affiliation(s)
- Josefine Cederhag
- Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden
| | - Durer Iskanderani
- Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden.,Department of Oral & Maxillofacial Radiology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.,Specialized Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Malmö University, Malmö, Sweden.,Section of Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway
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Brasil DM, Merken K, Binst J, Bosmans H, Haiter-Neto F, Jacobs R. Monitoring cone-beam CT radiation dose levels in a University Hospital. Dentomaxillofac Radiol 2023; 52:20220213. [PMID: 36802857 PMCID: PMC9944015 DOI: 10.1259/dmfr.20220213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/24/2022] [Accepted: 01/10/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. METHODS An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. RESULTS A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. CONCLUSIONS Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.
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Affiliation(s)
| | - Karen Merken
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium
| | - Joke Binst
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Establishment of Diagnostic Reference Levels in Cone Beam Computed Tomography Scans in the United Arab Emirates. Tomography 2022; 8:2939-2945. [PMID: 36548539 PMCID: PMC9783302 DOI: 10.3390/tomography8060247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
This study aimed to address the knowledge gap in assessing the radiation doses from cone beam computed tomography (CBCT) procedures, establishing a typical value, and estimating effective and organ doses. A total of 340 patients aged 18-80 years were included in this study. Organ doses were estimated using VirtualDose IR software. The typical values were based on median values estimated as 1000 mGy cm2. The mean ED (µSv) per procedure was 149.5 ± 56, and the mean of the peak skin dose during the CBCT examination was 39.29 mGy. The highest organ dose was received by the salivary glands (2.71 mGy), the extrathoracic region (1.64 mGy), thyroid (1.24 mGy) and eyes (0.61 mGy). The patients' doses were higher than in previous studies. Staff awareness, education, training and dose optimisation are highly recommended. With the establishment of local DRLs, patient dosages can be reduced successfully without compromising image quality.
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Geist JR. Image properly: Diagnostic reference levels and optimization in oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:359-361. [PMID: 35183482 DOI: 10.1016/j.oooo.2021.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
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Hung K, Hui L, Yeung AWK, Jacobs R, Leung YY, Bornstein M. An analysis of patient dose received during cone beam computed tomography in relation to scan settings and imaging indications as seen in a dental institution in order to establish institutional diagnostic reference levels. Dentomaxillofac Radiol 2022; 51:20200529. [PMID: 35230883 PMCID: PMC10043612 DOI: 10.1259/dmfr.20200529] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the dose-area product (DAP) of cone-beam computed tomography (CBCT) examinations for different scan settings and imaging indications, and to establish institutional diagnostic reference levels (DRLs) for dose optimization. METHODS A retrospective analysis of the DAP values of 3568 CBCT examinations taken from two different devices at the Prince Philip Dental Hospital, Hong Kong between 2016 and 2021 was performed. Patient- (age, gender, and imaging indication) and imaging-related (CBCT device, field-of-view (FOV), and voxel size) were correlated with the DAPs. The indication-oriented third-quartile DAP values were compared with DRLs from the UK, Finland, and Switzerland. The obtained third-quartile DAPs lower than the national DRLs and those for which no national DRLs have been proposed were used to establish institutional DRLs. RESULTS In the investigated CBCTs, the DAP value for large FOV scans was significantly lower than medium/small FOVs. CBCTs with a small voxel size exhibited a significantly higher DAP than those with a medium/large voxel size. CBCTs for endodontic, periodontal, orthodontic, or orthognathic evaluation exhibited a significantly higher DAP than other indications. Twelve indication-oriented institutional DRLs were established and five of them were lower than the national DRLs: third molars (229 mGy×cm2), jaw cysts/tumors (410 mGy×cm2), maxillary sinus pathology (520 mGy×cm2), developing dentition (164 mGy×cm2), and periapical lesions (564 mGy×cm2). CONCLUSIONS CBCT examinations for endodontic, periodontal, orthodontic, or orthognathic evaluation may deliver a higher radiation dose to the patient than other imaging tasks. A periodic review of the patient dose from CBCT imaging and establishment of institutional DRLs for specific clinical settings are needed for monitoring patient dose and to optimize indication-oriented scanning protocols.
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Affiliation(s)
- Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Liuling Hui
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael Bornstein
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Jose A, Kumar AS, Govindarajan KN, Sharma SD. Assessment of Regional Diagnostic Reference Levels in Dental Radiography in Tamil Nadu. J Med Phys 2022; 47:86-92. [PMID: 35548027 PMCID: PMC9084574 DOI: 10.4103/jmp.jmp_119_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 11/07/2022] Open
Abstract
Aim The aim of this article is to assess Tamil Nadu adult diagnostic reference levels (DRLs) by collecting radiation dose data from the four different dental modalities. Materials and Methods The study was carried out using routine adult exposure settings in 131 intraoral, 75 panoramic, 35 cephalometric, and 10 dental cone beam computed tomography (CBCT) X-ray devices. DRLs were assessed for intraoral and extraoral (panoramic, cephalometric, and CBCT) examinations in terms of incident air kerma (Ka, i) and kerma area product (PKA), respectively. Air kerma measurements, for all dental units, were made using calibrated RTI black Piranha 557 dosimeter (RTI Electronics AB, Sweden). The dosimeter was kept at the exit cone of the X-ray tube and on the detector side of the X-ray unit for intraoral and extraoral air kerma measurements, respectively. The obtained air kerma in extraoral modalities is multiplied with the beam area to evaluate PKA. Results The third quartile values calculated from the median for adult intraoral (mandibular molar), panoramic, cephalometric, and CBCT were 1.5 mGy, 116 mGycm2, 40 mGycm2, and 532 mGycm2, respectively. The proposed DRL in the present study was comparable to those reported in Germany, Greece, the UK, Japan, and Korea. Conclusion This study revealed the need for dose management and radiation dose optimization, in various dental facilities in the state. It was also found that dental facilities employed with the digital type of detector are not always related to lower exposure.
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Affiliation(s)
- Amal Jose
- Department of Medical Physics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - A. Saravana Kumar
- Department of Medical Physics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India,Address for correspondence: Dr. A. Saravana Kumar, Department of Medical Physics, PSG Institute of Medical Sciences and Research, Coimbatore - 641 004, Tamil Nadu, India. E-mail:
| | - K. N. Govindarajan
- Department of Medical Physics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Sunil Dutt Sharma
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Anushaktinagar, Mumbai, Maharashtra, India
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Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden. Clin Oral Investig 2021; 26:2073-2083. [PMID: 34596771 PMCID: PMC8816342 DOI: 10.1007/s00784-021-04189-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/17/2021] [Indexed: 11/14/2022]
Abstract
Objectives To query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences. Materials and methods Members of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality. Results The response rate was 64%. Panoramic radiographs were most commonly used in pre-surgical planning (response options: always or often), significant difference between professions (p = 0.039), and considered to facilitate treatment planning (87%), as was CBCT (82%); for 51%, CBCT reduced post-operative complications. Preferred modality for localizing the mandibular canal was fairly evenly distributed and for non-complex case, significant difference between subgroups of OMFS surgeons was found (p = 0.003) as to preference for intraoral radiographs. Conclusions A majority of respondents received a report within 2 weeks of their referral for CBCT and would read the report and view the images before surgery. Image modality preference differed depending on case complexity, with a greater perceived need for CBCT. Profession and practical experience affected choice. Clinical relevance Choice of imaging modality in mandibular third molar assessment is also important from dose delivery and social economy standpoints. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04189-9.
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Esmaeilyfard R, Samanipour A, Paknahad M. A cloud-fog software architecture for dental CBCT dose monitoring using the DICOM structured report: Automated establishment of DRL. Phys Med 2021; 89:147-150. [PMID: 34365119 DOI: 10.1016/j.ejmp.2021.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The diagnostic reference level (DRL) has been established to optimize the diagnostic methods and reduce radiation dose during radiographic examinations. The aim of this study was to present a completely new solution based on Cloud-Fog software architecture for automatic establishment of the DRL values during dental cone-beam computed tomography (CBCT) according to digital imaging and communications in medicine (DICOM) structured reports. METHODS AND MATERIALS A Cloud-Fog software architecture was used for automatic data handling. This architecture used the DICOM structured reports as a source for extracting the required information by fog devices in the imaging center. These devices transferred the derived information to the cloud server. The cloud server calculated the value of indication-based DRL in dental CBCT imaging based upon the parameters and adequate quantities of the absorbed dose. The feedback of DRL value was continuously announced to the imaging centers in 6 phases. In each phase, the level of the dose was optimized in imaging centers. RESULTS The DRL value was established for 5-specific indications, including third molar teeth (511 mGy.cm2), implant (719 mGy.cm2), form and position anomalies of the tooth (408 mGy.cm2), dentoalveolar pathologies (612 mGy.cm2), and endodontics (632 mGy.cm2). The determination of the DRL value in each phase revealed a downward trend until stabilization. CONCLUSION The new solution presented in this study makes it possible to calculate and update the DRL value nationally and automatically among all centers. Also, the results showed that this approach is successful in establishing stabilized DRL values.
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Affiliation(s)
- Rasool Esmaeilyfard
- Computer Engineering and Information Technology Department, Shiraz University of Technology, Shiraz, Iran; Health Technology Research Center, Shiraz University of Technology, Shiraz, Iran
| | - Ali Samanipour
- Computer Engineering and Information Technology Department, Shiraz University of Technology, Shiraz, Iran
| | - Maryam Paknahad
- Oral and Dental Disease Research Center, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran; Oral and Maxillofacial Radiology Department, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran.
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Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: An updated review. Phys Med 2021; 88:193-217. [PMID: 34284332 DOI: 10.1016/j.ejmp.2021.07.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/16/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
Cone beam computed tomography (CBCT) is a diverse 3D x-ray imaging technique that has gained significant popularity in dental radiology in the last two decades. CBCT overcomes the limitations of traditional two-dimensional dental imaging and enables accurate depiction of multiplanar details of maxillofacial bony structures and surrounding soft tissues. In this review article, we provide an updated status on dental CBCT imaging and summarise the technical features of currently used CBCT scanner models, extending to recent developments in scanner technology, clinical aspects, and regulatory perspectives on dose optimisation, dosimetry, and diagnostic reference levels. We also consider the outlook of potential techniques along with issues that should be resolved in providing clinically more effective CBCT examinations that are optimised for the benefit of the patient.
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Affiliation(s)
- Touko Kaasalainen
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland.
| | - Marja Ekholm
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520 Turku, Finland; South West Finland Imaging Center, Turku University Hospital, Lemminkäisenkatu 2, 20520 Turku, Finland
| | - Teemu Siiskonen
- Radiation Practices Regulation, Radiation and Nuclear Safety Authority - STUK, P.O. Box 14, FI-00881 Helsinki, Finland
| | - Mika Kortesniemi
- HUS Diagnostic Center, Radiology, Helsinki University and Helsinki University Hospital, P.O. Box 340, Haartmaninkatu 4, 00290 Helsinki, Finland
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