Learning objectives
1.
To familiarize the viewer with the radiographic and cone-beam computed tomography (CBCT) findings of dental,
alveolar and maxillofacial fractures
2.
To present how the different multi-planar reformatted CBCT sections and three-dimensional reconstructions show dentomaxillofacial fractures.
Background
Three-dimensional imaging methods are used in the diagnosis of dentomaxillofacial fractures however,
the use of conventional computed tomography (CT) is limited in dental practice due to high radiation doses,
metal artifacts,
costs,
and accessibility.
CBCT,
on the other hand,
has been improved to offer access to cross-sectional imaging that is faster and easier than conventional CT.
CBCT is based on a divergent cone- or pyramidal-shaped x-ray beam and an imaging sensor that are used to produce three-dimensional digital images.
CBCT units allow different voxel resolutions...
Findings and procedure details
Injuries to the dental hard tissues and the pulp
1.
Infraction: An incomplete fracture (crack) of the enamel without loss of tooth structure.
Imaging techniques: Periapical radiograph,
unless other symptoms are present.
Imaging features: No radiographic abnormalities are present but a fracture line on the surface of the tooth is visible clinically.
2.
Enamel fracture: A fracture confined to the enamel with loss of tooth structure (Fig.
2).
Imaging techniques: Periapical radiographs at different horizontal angles to rule out the possible presence of a root...
Conclusion
The detection of fracture lines and visualization within the dentoalveolar region using CBCT is superior to using conventional radiographs.
On the other hand,CBCT would not be the primary choice of imaging in the diagnosis of maxillofacial traumatic fractures because of the lack of soft tissue differentiation,
and CT has the advantage of showing both the bony structuresand soft tissues.
However,
multiplanar reformation,ray sum and volume rendering format options of CBCT provide images useful in the diagnosis of bone fractures.
Hence,
updated knowledge about the advantages...
Personal information
Aydin U.
Department of Dentomaxillofacial Radiology,
Faculty of Dentistry,
Baskent University,
Ankara,
Turkey
Gormez O.
Department of Dentomaxillofacial Radiology,
Faculty of Dentistry,Suleyman DemirelUniversity,
Isparta,
Turkey
Yildirim D.
Department of Dentomaxillofacial Radiology,
Faculty of Dentistry,Suleyman DemirelUniversity,
Isparta,
Turkey
References
1.
http://www.dentaltraumaguide.org/ Accessed 13 December 2015
2.
Aydin U.
Diagnostic methods in vertical root fractures (in Turkish).
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3.
Cohenca N,
Simon JH,
Roges R,
Morag Y,
Malfaz JM.
Clinical indications for digital imaging in dento-alveolar trauma.
Part 1: Traumatic injuries.
Dent Traumatol 2007;23(2):95-104.
4.
Kaeppler G,
Cornelius CP,
Ehrenfeld M,
Mast G.
Diagnostic efficacy of cone-beam computed tomography for mandibular fractures.
Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116(1):98-104.
5.
Laine FJ,
Conway WF,
Laskin DM.
Radiology of maxillofacial trauma.
Curr...