Dental cone beam CT and its justified use in oral health care

While dental 2D radiology is still the most frequent diagnostic tool, the inherent nature of jaws and teeth might surely benefit from 3D diagnosis. Nowadays, dental cone beam computed tomography may offer high quality images at low radiation doses and costs. Yet, effective dose ranges of CBCT machines may easily vary from 10-1200 microsievert, being an equivalent of 2 to 240 dental panoramic radiographs. The same holds true for diagnostic image quality, which exhibits a huge variation amongst machines and parameter settings. For segmentation accuracy, lower limits of accuracy are around 200 micrometer, yet again, larger inaccuracies may apply. For linear accuracies, values below 500 micrometer are feasible, with some machines and CBCT parameter settings allowing linear accuracies of up to 200 micrometer. Apart from the radiodiagnostic possibilities, dental cone beam CT may offer a vast therapeutic potential, including possibilities for surgical guidance and further treatment via CAD/CAM solutions for crown and bridgework on teeth or implants. In conclusion, dental CBCT imaging could be justified when dealing with specific indications including jaw bone and maxillofacial surgery, endodontic retreatment, traumata, jaw bone lesions and TMJ pathology. Yet, guidelines for CBCT optimisation and justification are mandatory, especially when used for pediatric indications.