Benefits of CBCT

CBCT, defined as cone-beam computed tomography systems, is a dental imaging method that utilises the dental x-ray where the rays are divergent and form a cone, hence giving it the name cone-beam computed tomography. Clinicians make the best use of CBCT to diagnose their patients, which captures the data by the x-ray beam rotating around the patient’s head. It is a variation of the conventional multi-slice CT scan that is normally done in a hospital setting. Even though the technology has been in the market for over 15 years, clinicians are finding further applications of CBCT, which is now used extensively to visualise the dental anatomy, including teeth, mouth, jaw, nose, neck, etc, maxillofacial and ENT (ear/nose/throat) anatomy as well as other areas such upper cervical and even limbs.
There are numerous benefits of CBCT in various fields of dentistry, and it is used in the diagnosis and treatment of several diseases of the oral cavity. Let us have a quick look at the benefits of CBCT.

Benefits of CBCT in Dentistry

To put things into perspective, let’s compare the typical radiation doses from different dental imaging modalities:

  • Evaluate the abnormal set of teeth, teeth and jaw relationship, which gives valuable information regarding the oral anatomy. 
  • Plan dental implants. The condition of the jaw and the bone thickness, length, and all the relevant parameters can be well evaluated by this method of dental CT. 
  • Assess root canal treatments through cone beam scan. 
  • Get significant information regarding the periodontal condition of the oral cavity and bone diseases. 
  • See TMJ and irregularities so that issues related to them can be diagnosed easily. 
  • Problems with tooth roots and dental pulp are also detected through any cone-beam scan. 
  • The same is also useful in the field of orthodontics. 
  • Many oral cavity pathologies can be seen on a cone beam x-ray. 
  • Bone anatomy and fractures can also be well marked through CBCT. 
  • Sometimes a pain of unknown origin can get a diagnosis through CBCT.

Benefits in Maxillofacial Surgery

Maxillofacial surgery has immensely benefited from a cone-beam scan. Some of the benefits of this dental radiology modality are:

  • Evaluation of cleft lip and palate. Cleft lip and palate can be diagnosed, but their extent can also be measured easily with the help of cone-beam CT. 
  • It gives insight regarding third molars. The position, condition, e.g. (caries, root structure, and crown placement), difficulty level, and the relation with the bone are also determined through CBCT. 
  • Osteonecrosis of the jaw can be seen through CBCT. 
  • It can be used before surgical extraction to know the location and angulation of the impacted teeth. 
  • Cysts and tumours can be evaluated, and their prognosis can also be well established through the cone-beam scan. 
  • Location of the inferior alveolar nerve can be easily determined through CBCT, and thus it can immensely help with the safe extraction of teeth. 
  • It can be used in exposure of canine through surgery to place ortho bands. 
  • The extent of oral lesions can be determined through this dental scan. For example, a buccolingual extension of a lesion can be well established. 
  • The relationship between lesions and important landmarks is seen through CBCT to save nerves or organs from damage. 
  • It can differentiate malignant lesions from benign. For example, the borders of malignant lesions are irregular and can be easily seen on a CBCT. 
  • A cone beam scan can identify fracture sites in the oral cavity. 
  • It can very well identify craniofacial disorders and give a thorough evaluation of the problems of the nasal septum and the location of supernumerary teeth. 
  • It can help identify abnormalities in oral structures associated with syndromes. 

Benefits in ENT

  • Nasal fossa and sinuses can be easily seen through cone-beam x-ray.  
  • Pathologies such as effusion, mucosal thickening, and ostial obstruction can be visualised perfectly. Any sinus pathology, like a cyst, polyp, etc., is diagnosed through a cone beam. 
  • Aspergillus-induced calcification can be diagnosed and subsequently treated, and it’s a major use for ENT surgeons. 
  • The relationship of upper teeth with sinus is also determined through CBCT and helps assess accessory canals, some supernumerary teeth, etc. 
  • Bone pathology can be assessed through CBCT, and it is used for picturing of bone extension of infectious processes, which are of dental or sinus origin, some fine perforation or visible blurring of sinus floors as well as the cortices opposite to the dental sites, some intraosseous fistular trajectories, as well as thinning or blurring of walls of the sinus.
  • Surgeons can also assess anatomical structures post-operatively with the help of a cone-beam scan.
  • CBCT can also identify some pathologies of the salivary glands. 
  • This dental X-ray can effectively study the ossicular chain 
  • Chronic otitis, which is inflammation of otitis media, is also diagnosed through CBCT. 
  • In the case of cochlear implants, CBCT can provide valuable information.

Benefits of CBCT in chiropractor’s practise

Chiropractors have also readily used x-rays to improve the outcomes of their practices. One such example is by imaging the cervical spine through the CBCT. It helps chiropractors visualise the misalignment in the vertebral column. Anatomical differences are there, and these differences can be assessed in the best possible way by a CBCT scan. More varied angles of the spine can help diagnose problems well. There is ample information obtained from cervical spine scans, which is then well correlated with several other examination procedures such as nerve testing, balance or coordination testing, posture testing, some range of motion testing, and finally, orthopaedic testing. All these baseline testing are then interpreted very well in light of the patient’s injury, the current health status, and a detailed treatment plan is then devised to meet their treatment needs. 

CBCT in Implantology

  • Dentists can use the CBCT scan to chalk out where the sensory nerves are present to select the right implant length. This significantly helps decrease the risk of nerve damage while placing the implant. 
  • Dental CBCT can be well justified for pre-surgical diagnosis, pre-surgical planning, and preoperative transfer for oral implant placement. 
  • It very well assesses the bone quality and thickness for implant placement. 
  • It can evaluate bone loss also if any, to assess the viability of the implant placement.
  • Computer-generated scans and surgical guides can provide more precise placement and accuracy. It is well designed for the drill to stop at the exact position and depth that has been planned. This tool easily saves valuable time, thus simplifying the whole implantology process and creating a wide-open field of view during surgery.
  • CBCT can make a fairly correct assessment of the shape and size of the ridge as well. 
  • It can assess the total number of implants required and identify the need for a sinus lift or bone graft for implant placement. 
  • Dental CT can easily assess implant position and angle, whether bone graft or angulated implants are required to avoid bone graft.

CBCT in Endodontics

  • Periapical pathology diagnosis – CBCTs are highly specific and sensitive in the proper diagnosis of periapical pathology compared to the simpler periapical radiographs. 
  • Dentoalveolar trauma – CBCT can specifically detect any dentoalveolar trauma where usual radiographic assessments are of limited use. 
  • It can also visualise complex root anatomy and thus can further aid with easy or difficult extraction diagnosis. 
  • CBCT can also assess post-treatment complication, such as fracture of a root that  can be noted on a CBCT scan.
  • It can also show root resorption clearly and subsequently help the dentist plan treatment accordingly. 
  • In cases of surgical endodontic procedures, CBCT can be of major use. 
  • The help of CBCT can take working radiographs that determine working length. 
  • For postoperative radiographs, CBCT is a great choice. It can help is evaluate the sealing after obturation.

Conclusion

The main advantage of CBCT is that the radiographic method has changed the treatment process immensely and has helped clinicians diagnose better than before. The 3D nature of the x-ray has helped the dentist view the mouth from different angles and thus can identify structures that can stay hidden with a conventional x-ray technique. Far better image quality is achieved with the help of the CBCT X-ray. It is a very painless and quick procedure to help physicians with the diagnosis. Localisation of jaw bone can be done easily.

3Beam is London’s leading cone beam CT scan referral imaging centre located on 86 Harley Street, delivering dental, maxillofacial and ENT CBCT scans 6 days a week. Working in partnership with UK-based dental as well as head and neck consultant radiologists, 3Beam Imaging Centre provides full radiology reporting services of the highest quality and standard. 3Beam is headed by UK-trained healthcare professionals with extensive NHS experience and background – Dr Emil Gadimali MBBS MBA and Mr Ashir Patel (Radiographer).