Department of Oral Maxillofacial Surgery and Oral Diagnosis, Kulliyyah of Dentistry, International Islamic University Malaysia, Pahang, Malaysia
Submitted: 11-Nov-2020
Accepted in Revised Form: 21-Nov-2020
Published: 28-Jan-2021
DOI: 10.4103/sidj.sidj_48_20
Saint Int Dent J 2020;4:76.
Copyright: © 2020 The Saint's International Dental Journal
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This article was originally published by Wolters Kluwer Medknow Publications & Media Pvt ltd and has now been officially transferred to Society of Dental Research & Education due to a change in publishing entity.
Besides panoramic radiograph, cone-beam computed tomography (CBCT) can be acknowledged as one of the most crucial technologic achievements in dentistry. It utilizes the cone-shaped or pyramid-shaped X-ray source and can be viewed in multiplanar images, providing a three-dimensional view of the maxillofacial region.[1] The machine has a relatively small size, but it generates more radiation dose than other conventional dental imaging modalities[2] while lower than the medical CT. The radiation dose depends on several factors, such as field of view (FOV) size and other technical factors such as the resolution of the image.[3] There are many applications of CBCT in the dental clinic. It is advantageous to use treatment planning in oral surgery cases such as an impacted tooth, implant planning, orthodontics, periodontics, temporomandibular joint diseases, CBCT sialography, obstructive sleep apnea, and other maxillofacial pathology imaging.[1,4]
CBCT has a separate limitation that clinicians should be aware of. It is sensitive to patient motion during the acquisition phase, having noise and low soft-tissue contrast compared to conventional medical CT and having metallic artifacts with beam hardening, scatter, and cupping appearance.[1]
All clinicians should be aware of the guidelines on CBCT imaging. There were 26 guidelines on the use of CBCT found in 2015, and there might be more in 2020. These guidelines include the patient selection criteria, the clinical use of CBCT in the dental setting, and various aspects of the tomographic radiology technique. CBCT should not be a routine examination. Each case should be selected individually and only used when necessary to balance the risk of exposing the patient to ionizing radiation. Children are more radiosensitive than adults; thus, choosing CBCT cases in children must be justified. A dentist prescribing CBCT must be responsible for the image taken.[4]
Dentists with CBCT machines must have proper training, especially regarding selection criteria and “As Low As Reasonably Achievable” principles. Sole training by salespeople should be avoided.[3] Concerning the COVID-19 pandemic, all clinicians should follow the established guideline when prescribing a radiographic examination. Each patient should be screened beforehand to ensure the
safety of healthcare providers and other patients. Patient selection, precautions during the radiographic examination, and postimaging room cleaning should be made. Small FOV CBCT might be considered one imaging modality since it does not induce aerosol from gagging.[2] The recently published guideline should be read carefully by each clinician and followed thoroughly to prevent infection spread.
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