CONE BEAM COMPUTED TOMOGRAPHY

Small Cone Big Scoop

INTRODUCTION
Cone beam computed tomography is recent advancement in diagnostic
imaging which has bigen to emerged as a potentially low dose imaging
techniques for visualization of bone pathologies

HISTORY
July 1, 1956 as CFCY-TV, under the ownership of the Rogers family and their company
Family patriarch Col
rebroadcaster in Charlottetown in 1972

HISTORY
Cone beam technology was first introduced in the European market in 1996 by
QR s.r.l. (NewTom 9000) and into the US market in 2001.[2]

October 25, 2013, during the "Festival della Scienza" in Genova, Italy, the original
members of the research group: Attilio Tacconi, Piero Mozzo, Daniele Godi and
Giordano Ronca received an award for the cone-beam CT invention, a
revolutionary invention that changed world's dental radiology panorama.[5][6][7]
CBCT USE IN IMPLANTOLOGY
A dental cone beam scan offers invaluable information when it comes to the
assessment and planning of surgical implants. The AAOMR also suggests conebeam CT as the preferred method for presurgical assessment of dental implant
sites.
CBCT USE IN ORTHODONTICS
As a 3D rendition, CBCT offers an undistorted view of the dentition that can be
used to accurately visualize both erupted and non-erupted teeth, tooth root
orientation and anomalous structures that conventional 2D radiography cannot.
Processing example using x-ray data from a tooth model:

DISADVANTAGES OF CBCT TECHNOLOGY

There are a number of drawbacks of CBCT technology over that of medicalgrade CT scans, such as increased susceptibility to movement artifacts (in first
generation machines) and to the lack of appropriate bone density determination
ADVANTAGES OF CBCT TECHNOLOGY
CBCT is well suited for imaging the craniofacial area. It provides clear images of
highly contrasted structures and is extremely useful for evaluating bone. The use
of CBCT technology in clinical practice provides a number of potential
advantages for maxillofacial imaging compared with conventional CT:

X-ray beam limitation: Reducing the size of the irradiated area by

collimation of the primary x-ray beam to the area of interest minimizes the

radiation dose. Most Cone Beam CT units can be adjusted to scan small regions
for specific diagnostic tasks. Others are capable of scanning the entire
craniofacial complex when necessary.

Image accuracy: The volumetric data set comprises a 3D block of smaller

cuboid structures, known as voxels, each representing a specific degree of x-ray
absorption. The size of these voxels determines the resolution of the image. In
conventional CT, the voxels are anisotropic rectangular cubes where the longest
dimension of the voxel is the axial slice thickness and is determined by slice
pitch, a function of gantry motion. Although CT voxel surfaces can be as small as
0.625 mm square, their depth is usually in the order of 12 mm. All CBCT units
provide voxel resolutions that are isotropic equal in all 3 dimensions. This
produces sub-millimetre resolution (often exceeding the highest grade multi-slice
CT) ranging from 0.4 mm to as low as 0.125 mm (Accuitomo).

Rapid scan time: Because Cone Beam CT acquires all basis images in a
single rotation, scan time is rapid (1070 seconds) and comparable with that of
medical spiral MDCT systems. Although faster scanning time usually means
fewer basis images from which to reconstruct the volumetric data set, motion
artifacts due to subject movement are reduced.
INDICATION
The aim of this study was to identify specific indications for dental cone-beam
computed tomography (CBCT) in the field of oral and maxillofacial surgery. To
this end, we compared the efficacy of CBCT to that of panoramic radiography,
the standard imaging modality, for the evaluation of different surgical questions in
the oral and maxillofacial region. Dentall CBCT proved to be particularly useful in
cases where visualization of a second plane is necessary for implant planning or
for pre-surgical evaluation of retained and displaced teeth posing a risk to
adjacent structures. It is also indicated for precise localization of luxated teeth
and dental implants dislocated into surrounding areas, localization of the
mandibular canal to assess its anatomical relationship to overfilled root canal
filling materials, assessment ofthe extent of osseous lesions, and evaluation of
patients with suspected mandibular or condylar fractures. The main advantages
of CBCT are reduction of the risks of surgery due to the free selection of imaging
planes, maindibular canal marking, 1:1 magnification, and the ability to use
DICOM data in other implant or surgical planning software. Adequate user
experience is important for proper evaluation of dental CBCT scans, as is the
diagnosis of incidental findings falling into areas not primarily related to dentistry
and therefore requiring additional investigation.