Dose optimization in CBCT in dentistry: a survey among EADMFR members

The aim of this study is to provide an overview of current cone beam CT (CBCT) practices in European dental clinics.

From February to May 2023, 186 European EADMFR members were invited to complete an online survey. Participants were asked: (1) to provide exposure settings for 4 diagnostic scenarios; (2) if and how they adjust for age and body type; (3) whether they follow established protocols when selecting settings; and (4) if the Dose Area Product (DAP) is registered for CBCT scans.

A total of 59 (32%) eligible responses were received. There was a large variation in exposure parameters among clinicians within the same diagnostic scenario. Across scenarios, only voxel size and field of view (FOV) differed significantly (P < .05), with smaller settings being chosen for endodontic diagnostics and larger parameters for full-jaw imaging for implant planning. For young patients, most respondents reduced FOV (70%), mA (67%), and exposure time (59%). For larger patients, most increased mA (54%) and kV (52%). Written protocols were more frequently employed than manufacturer-recommended settings (75% vs 50% reported "most of the time" or "always"). More frequent usage of manufacturer-recommended settings correlated with larger FOV settings (P < .05). 90% reported registering the DAP.

CBCT exposure parameter selection lacks consistency. Only FOV and voxel size were consistently adjusted for the indication. New guidelines providing guidance on the selection of CBCT settings could reduce variation between clinicians and enhance the uniformity of the quality of care.

Lack of uniformity in CBCT parameter selection highlights the need for updated, indication-oriented, and patient-specific guidelines.