Cone-Beam CT Diagnostic Applications: Caries, Periodontal Bone Assessment, and Endodontic Applications

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Cone-beam CT (CBCT) is useful for many maxillofacial applications, such as implant site imaging and diagnosis and treatment planning for orthodontics and craniofacial surgery. Dentoalveolar applications, such as carious lesion detection and characterization, assessment of the three-dimensional nature of periodontal bone topography, and various endodontic applications are less known and not as thoroughly studied. This article explores and assesses in vivo and in vitro efforts to apply CBCT imaging to these more common dentoalveolar tasks. CBCT imaging, like its medical counterpart, can be seen as a highly useful and, in some instances, indispensable part of the dental imaging armamentarium.

Section snippets

Caries diagnosis

The detection of proximal and occlusal surface caries by conventional intraoral 2D methods has demonstrated only low-to-moderate sensitivity, but slightly better specificity, and high observer variability [20], [21], [22], [23], [24], [25], [26]. Pervious extraoral imaging methods for caries detection have met with limited success and dubious clinical applications. CBCT imaging appears to be the best prospect for improving the detection and depth assessment of caries in approximal and occlusal

Periodontal applications

In his 2004 summary of periodontal imaging methods in Periodontology, Mol states, “Relatively few technologies have emerged to address the critical needs in periodontal diagnosis” [11]. He goes on to point out that although digital imaging has added value to intraoral imaging, an increase in diagnostic capabilities has not been one of the benefits. Mol discusses the limitations of extraoral imaging (panoramic) with its associated drawbacks but does point out the usefulness in association with

Endodontic applications

It is in the area of endodontic applications that the literature has proved most fruitful to date. Endodontic applications include the diagnosis of periapical lesions due to pulpal inflammation, visualization of canals, elucidation of internal and external resorption, and detection of root fractures. As is the case with the previous two categories, most published articles are either case reports or in vitro studies.

Current 2D technologies are film and digital based. Stavropoulos and Wenzel [46]

Summary

In summary, several important points should be considered:

  • 1.

    Only a modest amount of research has been undertaken in the field of CBCT and dentoalveolar applications. Certainly, more in vivo and in vitro studies are needed for this field to reach full maturation. More clinical studies are needed, preferably random double blind clinical trials. In addition, the effect of motion needs to be assessed for all three categories of dentoalveolar tasks surveyed in this article.

  • 2.

    CBCT and caries research

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