CBCT

Key points

CBCT offers decreased irradiation dose vs spiral CT scan
Radiation dose dependent on mA and exposure time; not on voxel size
Dimensional accuracy has been proven to be high
Different hardwares offer variety of fields of view (such as 4 x 4 to 15 x 20 cm) according to the clinical indication
Both 2D and 3D images can be obtained
Hounsfield unit measurements not as reliable as on spiral CT
Integrating a planned or existing prosthetic device in the images is unvaluable for treatment planning

CBCT Considerations

Radiation source collimated at its source and then diverges into a fan shape to reach detectors. This results in a cone beam.
Pixel (picture + element) is the smallest single component of a 2-D image, whereas a voxel is the smallest element in 3-D environment.
Large fields of view (FOV) visualize both jaws and their relationship.
Small FOVs offer detailed images of bone trabeculae and cortex.
Grayscale values vary for specific tissues within the image and are not as reliable as in spiral CT.
CBCT can detect clinically relevant structures which are not visible on panoramic/intra-oral radiographs, such as the incisor canal, lingual concavities and missing osseous cortex

CBCT 2-D image, showing the mesial extension of the incisor canal
The CBCT is essential for preoperative planning and CAD-CAM manufacturing of drill guides and/or prostheses
Except for gray values, CBCT provides information as accurately or even better as spiral CT, with less radiation exposure and costs

Clinical topics

Treatment guidelines

Digital treatment planning protocols, introduction

Spiral or Cone Beam CT (CBCT) data sets of the patient jaw bones and of the scan template are transcoded by a specific software to produce three-dimensional (3-D) images of the jaw bones and thickness of the mucosa. Software planning...

Treatment guidelines

Digital treatment planning protocols, NobelClinician

The NobelClinician™ software solution is a digital tool for diagnostics, treatment planning and patient communication. Patient scans are integrated in the software for identification, mapping and diagnosis of anatomical structures. In a terminal dentition...

Treatment guidelines

Imaging tools overview

Because any form or radiation can impose a risk, patient history and clinical examination should be performed first to ensure that the right kind of imaging is sought and unhelpful imaging is avoided.
The four main types of imaging tools utilized, and...

Radiology

Additional resources

Videos

Andrew Dawood: Impact of imaging on treatment planning

The lecture gives insight in the tremendous change, advanced imaging techniques can provide to implant dentistry and dentistry in general. Dr Dawood presents examples where 3D visualization is able to reveal surprising diagnostic findings having a strong influence on treatment...

Videos

Luc Vrielinck: Accuracy in planning - stability in positioning - versatility in execution

Supported by a clinical patient example, Dr Vrielienk presents his first experiences applying a new, innovative, simplified digital workflow protocol and reviews the treatment steps and advantages. In comparison to previous workflow protocols, which at times were a logistical...