The Why, When and Which of 3D Imaging by Dr. Lea Al Matny Is now the time to implement cone beam technology in your practice? For more than a decade, cone beam computed tomography (CBCT) has been changing the way doctors diagnose and treat patients. This imaging modality gives doctors a three-dimensional view of dentomaxillofacial structures and these can be the difference between solving the mystery of a patient’s pain or missing a vital indicator. As more doctors adopt this technology, it’s important to understand why we need to implement CBCT; when it is beneficial; and which system best suits your practice to safely and effectively image patients

Diagnosis using panoramic radiographs and periapical radiographs are limited because they provide a two-dimensional (2D) image of three-dimensional (3D) structures, with distortion, magnification and loss of definition due to superimposition of underlying structures. Evaluating anatomical structures using 3D imaging allows a practitioner to properly assess a case without making assumptions. Take for instance the different views below that CBCT can provide. For doctors new to CBCT, the orthogonal planes of space are worth reviewing. Axial View: Why Do You Need CBCT? Coronal View: Sagittal View:...

Doctors who are new to three-dimensional imaging risk falling into one of two traps: Using their new system on every patient or not using the system to its full advantage and missing opportunities to enhance diagnoses. To determine when a CBCT scan might be beneficial, ask these questions: • Are my clinical findings inconclusive? • Can a 3D view affect my treatment plan? • Will it help me localize the pathology? If the answer is yes to any of these questions, a CBCT scan may be helpful. 2. During Endodontic Treatment Evaluation/Assessment/Applications 4. Temporomandibular Joint Assessment Read...

When Do You Need CBCT? 1. Surgical assessment BENEFITS: • Evaluate trabecular bone pattern prior to implant placement Sagittal view of posterior mandible: Evaluation of partially integrated graft material prior to implant planning (Figure 1). Sagittal views of posterior right mandible showing horizontally impacted #32 causing apical root resorption on distal aspect of #31 (Figure 5 and 6). • Prosthetically driven implant planning Volume rendering of anterior maxilla demonstrating prosthetically driven implant planning on #10 (Figure 2). Cropped panoramic reconstruction of posterior left mandible...

When Do You Need CBCT? 2. Endodontic treatment evaluation* BENEFITS: •P re-operative: Detect the presence of periapical disease; identify the potential for extra canals; suspected complex morphology and dental anomalies •P ost-operative: Determine the prognosis of a nonhealing endodontic treatment; detect vertical root fracture; localize perforations and assess complications Sagittal view of #30: Periapical rarefying osteitis surrounding mesial and distal apices (Figure 1). Cross-sectional view of endodontically treated #3 with periapical rarefying osteitis most probably due to untreated/unobturated...

When Do You Need CBCT? 3. Pathosis Evaluation BENEFITS: • Identify the area of interest • Localize the extent of pathosis and effect on surrounding anatomical structures • Determine differential diagnosis and prognosis depending on radiographic behavior of entity. Series of axial views of the posterior left mandible showing low-density lesion surrounding crown of impacted #20 (Figures 1, 2 and 3). Sagittal and axial views demonstrating cystic lesion in anterior maxilla (Figure 4 and 5).

When Do You Need CBCT? 4. Temporomandibular Joints AssessmentBENEFITS: • Localize osseous pathosis in condyle and mandibular fossa • Evaluate relationship between condyle and mandibular fossa • Determine the presence of asymmetry between right and left temporomandibular joints Of course, the use of CBCT imaging is patient- and case-specific. Doctors should always apply the ALARA principle when they decide to use CBCT. Coronal and sagittal oblique views of right and left temporomandibular joints (Figure 1). Coronal and sagittal oblique views demonstrating condylar fracture in the left temporomandibular...

Which Features are Right for You and Your Patient? Make sure you find the CBCT system that best suits your practice requirements and patients’ needs. Here are some questions to take into consideration when deciding on a CBCT machine: • How many procedures do you perform that require CBCT? • Do you want to expand the treatments you perform? • Is your practice multi-specialty? • Do you plan to add another specialist to your practice? • How are you currently working with referrals? Could your relationship with them be better? Turn to the next page to learn more! • What fields of view (FOVs) do you...

Connect with Dr. Lea to discuss the pros and cons of each. Email: [email protected] CS 8100 CS 8100SC CS 8100SC 3D Family 12x10 Edition 16x10 Edition 16x17 Edition 4 FOVs available: 4 or 6 FOVs available: 10 FOVs available: 12 FOVs available: 14 FOVs available:

Click here to learn more about the newest CBCT system, or visit carestreamdental.com to learn more about any of Carestream Dental’s innovative imaging technology. ABOUT LEA AL MATNY, DDS MS Dr. Lea Al Matny is a licensed Oral and Maxillofacial Radiologist at SeeThru Reports and Specialty Clinical Expert at Carestream Dental. She attended the University of Texas Health in San Antonio (UTHSA) where she received both a certificate in Oral and Maxillofacial Radiology and a master’s degree in Dental Science. She is a reviewer for Oral Surgery, Oral Pathology, Oral Medicine and Oral Radiology (OOOO)...

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