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Cone Beam CT Scan (CBCT) And How Does it Work?
CBCT SCAN
Dental cone beam computed tomography is a medical imaging technique consisting of X-ray computed tomography where the X-ray are divergent. It is mostly used in conditions where normal dental or facial X- rays are not enough. CBCT is a radiographic imaging procedure that allows accurate, three-dimensional imaging of hard tissues. The radiation exposure from such type of scanner is ten times lower than a CT scan during maxillofacial exposure. CBCT scanner uses a special kind of technology to create three dimensional (3-D) images of dental structures, nerves path, soft tissues, and bones present in the facial region in a single scan.
With CBCT, an X-ray beam in the shape of a cone is moved around the patient to produce a large number of pictures. Dental cone beam CT scan was developed as a means of creating similar images but for a lower cost. A single projection image is known as “basis” images.
The scan provides detailed images of the bones, and is performed mainly on dentition, jaws, bony structures of the face, nasal cavity, and sinuses. However, the CBCT scan does not provide the full diagnostic information like conventional CT scan does, especially in the evaluation of soft tissue structures such as muscles, lymph nodes, glands, and nerves. The growing accessibility of this technology is now providing the dental clinician an imaging modality, which is useful in creating a 3-D representation of the maxillofacial structures with minimal radiation hazards.
CBCT VERSUS SPIRAL CT
The major difference between CBCT and spiral CT is that CBCT utilizes a cone-shaped beam and an area detector which catches a full volume of the picture in a single rotation. Patient movement is not needed. In spiral CT, it uses a narrowly collimated, fan-shaped beam of X-ray, which rotates around the patient’s head. The use of CBCT can nullify concerns like high radiation dosage, cost, sensitivity, patient safety, etc.
Clinical Applications In Maxillofacial Region
(1) In oral and maxillofacial surgery
The most important application of CBCT in oral and maxillofacial surgery is to inspect the exact 3-D location of jaw pathology such as benign or malignant tumour or inflammatory bone contusion. CBCT is also used to investigate the pathologies associated with paranasal sinuses and to assess obstructive sleep apnea. CBCT is not a magnetic resonance technique; therefore, it can be the best option for intra-operative evaluation during gun-shot injury, automobile, or industrial accidents. The technique is widely used in planning orthognathic and orthomorphic surgeries.
CBCT can also be used to measure the number of roots, determining root morphology, root, and accessory canals. It gives a more precise assessment of root canal treatment. In emergency cases that may require tooth assessment after any trauma, CBCT provides aid in determining a proper and suitable treatment approach.
(2) Implant Dentistry
The lower radiation doses of CBCT has made it a good option in implant dentistry. Effective implant planning using CBCT data permits the clinicians to predict and visualize the final result before starting the treatment. The assessment of the success of bone grafts and other bone-related treatment evaluations are also possible with the help of CBCT scan.
3) In Periodontics
High measurement precision with minimal chances of errors allows the use of CBCT scan in getting a detailed morphologic description of the bone. CBCT has made an exceptional contribution to an accurate evaluation of intra-bony defects, dehiscence, and periodontal therapy. It has made a valuable application that allows the evaluation for the analysis of buccal and lingual surfaces and improvises depth, height, and morphological defects.
OTHER USES OF CONE BEAM CT SCAN
The CBCT scan is commonly used in dental treatment planning. It is also useful in some complex cases such as:
- Surgical plan for impacted teeth
- Temporomandibular joint disorder
- Dental implants placements
- Evaluation of jaw, nerve canals, sinuses, etc.
- Bone structure and tooth orientation
- Locating the origin of pain
- Cephalometric analysis
PREPARATION FOR A CBCT SCAN
A cone-beam CT Scan requires no special preparations. However, prior to the scan, an individual may be asked to remove items that can interfere with the imaging, including metal objects, jewellery, hairpins, hair aids, etc.
How the Equipment Looks Like?
Cone beam CT scanners are square-shaped machines that include an upright chair or a moveable chair so that an individual can sit down during the scanning procedure. Scanners consist of a chair have a rotating C- arm, an X-ray intensifier containing X-ray source and detector.
HOW IS THE PROCEDURE PERFORMED?
A person will be asked to sit on the examination chair/stand/table, depending on the type of CBCT scanner being used. The technician will position the patient in the centre of the beam of the area of interest. An individual will be asked to stay still while the X-ray source and detector revolve around them.
BENEFITS VS. RISKS
Benefits
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The focused X-ray beam reduces the scatter radiation, resulting in much better image quality.
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A single scan produces a wide variety of angles and views that can be utilized to provide a complete evaluation.
- The CBCT scan is painless, accurate, and non-invasive.
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It has the ability to image both bone and soft tissue at the same time.
Risks
- CBCT scan may cause few exposures to radiations.
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Since children are more sensitive to radiation, they should have a CT scan only if it is mandatory for making a diagnosis. The scan in children should be done with a low dose technique
Note: Please always consult your physician before any scan.
Diagnostic and Pathology Tests Available At House of Diagnostics (HOD).
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