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Dental conebeamct
1. /7/711
Dental Cone Beam CTDental Cone Beam CT
Frank GoernerFrank Goerner
Graduate StudentGraduate Student
UT-Health Science Center San AntonioUT-Health Science Center San Antonio
2. /7/722
How CBCT WorksHow CBCT Works
Similar to currentSimilar to current
CT technologyCT technology
Uses cone shapedUses cone shaped
x-ray beamx-ray beam
2-D flat panel2-D flat panel
detectordetector
Gives volumetricGives volumetric
datadata
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Advantages in Dental ImagingAdvantages in Dental Imaging
Lower dose than helical CTLower dose than helical CT
Compact designCompact design
Superior images to PanoramicSuperior images to Panoramic
Low costLow cost
Low heat loadLow heat load
Dose:
Panoramic: 6-20 µSv
CBCT: 20-70 µSv
Conventional CT: 314 µSv
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ShortcomingsShortcomings
Metal artifacts?Metal artifacts?
Worse low contrast detectabilityWorse low contrast detectability
Long scan times = motion artifactsLong scan times = motion artifacts
Slightly Inferior quality to conventional CTSlightly Inferior quality to conventional CT
Periodontal ligament spaces easily recognizable in the
dental CT but not satisfactory in the CBCT
CBCT
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Applications of CBCTApplications of CBCT
Great for pre-planning for implant surgeryGreat for pre-planning for implant surgery
Virtual SurgeryVirtual Surgery
Conventional CT diagnosis at 1/5 the doseConventional CT diagnosis at 1/5 the dose
Tumor detectionTumor detection
Airway visualizationAirway visualization
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ConclusionsConclusions
CBCT offers less dose than conventional CTCBCT offers less dose than conventional CT
CBCT offers superior images and diagnosis toCBCT offers superior images and diagnosis to
panoramicpanoramic
More practical than a conventional CTMore practical than a conventional CT
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ReferencesReferences
Jaffray DA, Siewerdsen JH. Cone-beam computed tomography with a flat-panel imager: initial performance characterization. Med PhysJaffray DA, Siewerdsen JH. Cone-beam computed tomography with a flat-panel imager: initial performance characterization. Med Phys
2000;27:1311-232000;27:1311-23
Sukovic P. Cone beam computed tomography in craniofacial imaging.Orthod. Craniofacial Res. 6 (Suppl. 1), 2003; 31-36Sukovic P. Cone beam computed tomography in craniofacial imaging.Orthod. Craniofacial Res. 6 (Suppl. 1), 2003; 31-36
Holberg C, Steinhauser S, Phillip G, Rudzki-Janson I. Cone-Beam Computed Tomography in Orthodontics: Benefits and Limitations. JHolberg C, Steinhauser S, Phillip G, Rudzki-Janson I. Cone-Beam Computed Tomography in Orthodontics: Benefits and Limitations. J
Orofac Orthop 2005;66:434-44Orofac Orthop 2005;66:434-44
Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging forGuerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for
preoperative planning of implant placement. Clin Oral Invest (2006) 10:1-7preoperative planning of implant placement. Clin Oral Invest (2006) 10:1-7
Zhang Y, Zhang L, Zhu XR, Lee AK, Chambers M, Dong L. Reducing Metal Artifacts in Cone-Beam CT Images by PreprocessingZhang Y, Zhang L, Zhu XR, Lee AK, Chambers M, Dong L. Reducing Metal Artifacts in Cone-Beam CT Images by Preprocessing
Projection Data. Int. J. Radiation Oncology Biol. Phy., Vol. 67,No. 3, pp. 924-932, 2007Projection Data. Int. J. Radiation Oncology Biol. Phy., Vol. 67,No. 3, pp. 924-932, 2007
Tsurumachi T, Honda K. A new cone beam computerized tomography system for use in endodontic surgery. International EndodonticTsurumachi T, Honda K. A new cone beam computerized tomography system for use in endodontic surgery. International Endodontic
Journal, 40, 224-232, 2007Journal, 40, 224-232, 2007
Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. Eur. Radiol. 8, 1558-1564 (1998)Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. Eur. Radiol. 8, 1558-1564 (1998)
Winter AA, Pollack AS, Frommer HH, Koenig L. Cone Beam Volumetric Tomography vs. Medical CT Scanners. NYSDJ 2005 June/JulyWinter AA, Pollack AS, Frommer HH, Koenig L. Cone Beam Volumetric Tomography vs. Medical CT Scanners. NYSDJ 2005 June/July
28-3328-33
Questions?
9. March 6, 2008March 6, 2008
BureaBurea
u ofu of
RadioRadio
logicalogica
ll
HealtHealt
hh
Cone Beam ComputedCone Beam Computed
TomographyTomography
10. NewTom 3G by AFP MercuRay by Hitachi
3D Accuitomo
by J. Morita
Cone-beamCone-beam
UnitsUnits
Galileos by Sirona
I-CAT by ISI Iluma by IMTEC
14. Source;Source;
StuartStuart
White-White-
UCLAUCLA
SchoolSchool
ofof
DentistrDentistr
yy
Bureau IssuesBureau Issues
How to regulate these sources?How to regulate these sources?
– Appears that FDA has classified them as CTAppears that FDA has classified them as CT
If CT, subject to QA requirementsIf CT, subject to QA requirements
If CT, limited licensed technologistsIf CT, limited licensed technologists
prohibited from operating unitprohibited from operating unit
Your thoughts?Your thoughts?
15. Source;Source;
StuartStuart
White-White-
UCLAUCLA
SchoolSchool
ofof
DentistrDentistr
yy
Suggested RegulatorySuggested Regulatory
ApproachApproach
Advise all CBCT registrants that FDAAdvise all CBCT registrants that FDA
classifies as CT (Once we officiallyclassifies as CT (Once we officially
confirm)confirm)
Advise registrants that only the Dentist,Advise registrants that only the Dentist,
Physician, Dental Hygienist(?) orPhysician, Dental Hygienist(?) or
Diagnostic Technologist can operateDiagnostic Technologist can operate
CBCTCBCT
Provide registrants 90 days to developProvide registrants 90 days to develop
and 180 days to implement alternative QAand 180 days to implement alternative QA
program as permitted by N.J.A.C. 7:28-program as permitted by N.J.A.C. 7:28-
