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The Assessment of Dentists’ Knowledge Regarding Indications of Cone Beam Computed Tomography in Qazvin, Iran

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Abstract

Background: Cone beam computed tomography (CT) has recently become effective for oral and maxillofacial imaging. Objectives: The aim of this study was to assess the knowledge of dentists regarding cone beam computed tomography. Materials and Methods: In this descriptive cross sectional study, a questionnaire regarding cone-beam computed tomography (CBCT) was distributed amongst 100 dentists (general and specialist) in Qazvin, Iran. Their level of knowledge was compared in each section on the basis of age, gender, years of employment and last educational status and analyzed by the SPSS software and Mann-Whitney test. Results: Data analysis showed that 4% of dentists had very low, 16% had low, 50% had medium, 19% had good and 11% had in very good level of knowledge. The average of dentists’ knowledge was 57 ± 18. According to the statistical results, there was a significant difference between level of knowledge and age, years of employment and educational degree (P 0.05). Conclusions: Overall, dentists had an average level of knowledge for CBCT. It is recommended for qualification programs to be held for dentists to strengthen their awareness toward cone beam computed tomography. Keywords:Knowledge; Dentist; Cone - Beam Computed Tomography
Biotech Health Sci. 2015 February; 2(1): e25815.
Published online 2015 February 21. Research Article
The Assessment of Dentists’ Knowledge Regarding Indications of Cone
Beam Computed Tomography in Qazvin, Iran
Maryam Tofangchiha 1; Faraz Arianfar 1; Mahin Bakhshi 2; Mansour Khorasani 3,*
1Department of Oral Radiology, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, IR Iran
2Department of Oral Medicine, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
3Department of Oral and Maxillofacial Surgery, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, IR Iran
*Corresponding author: Mansour Khorasani, Department of Oral and Maxillofacial Surgery, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, IR Iran. Tel: +98-2813353061,
E-mail: vkhorasani1342@yahoo.com
Received: December 4, 2014; Accepted: January 18, 2015
Background: Cone beam computed tomography (CT) has recently become effective for oral and maxillofacial imaging.
Objectives: The aim of this study was to assess the knowledge of dentists regarding cone beam computed tomography.
Materials and Methods: In this descriptive cross sectional study, a questionnaire regarding cone-beam computed tomography (CBCT)
was distributed amongst 100 dentists (general and specialist) in Qazvin, Iran. Their level of knowledge was compared in each section on
the basis of age, gender, years of employment and last educational status and analyzed by the SPSS software and Mann-Whitney test.
Results: Data analysis showed that 4% of dentists had very low, 16% had low, 50% had medium, 19% had good and 11% had in very good
level of knowledge. The average of dentists’ knowledge was 57 ± 18. According to the statistical results, there was a significant difference
between level of knowledge and age, years of employment and educational degree (P < 0.05). Age and years of employment had a
reverse relationship with level of knowledge and specialists had greater awareness. There was no significant difference between level of
knowledge and sex (P > 0.05).
Conclusions: Overall, dentists had an average level of knowledge for CBCT. It is recommended for qualification programs to be held for
dentists to strengthen their awareness toward cone beam computed tomography.
Keywords:Knowledge; Dentist; Cone - Beam Computed Tomography
Copyright © 2015, School of Paramedical Sciences, Qazvin University of Medical Sciences. This is an open-access article distributed under the terms of the Creative
Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the mate-
rial just in noncommercial usages, provided the original work is properly cited.
1. Background
Cone-beam computed tomography (CBCT) is a new
technology, in which two-dimensional detectors and
conical beam are used instead of fan X-rays in conven-
tional computed CT. In this technique, volumetric data
are collected by rotating of beam and detectors around
the desired structure (1). The main advantage of CBCT is
its high sharpness of axial images compared to conven-
tional CTs (2). Ludlow and colleagues showed that CBCT
dosages can be different according to the manufacturer
company, type of machine, type of observer and level of
elective exposure factors (3).
In the recent years, this technology has been used to
prepare cross-sectional images from maxillofacial struc-
tures. Cone-beam computed tomography has less expo-
sure time and cost compared to conventional CT. The
beams rays are confined for head and neck only. Lower
dosage of X-rays and ability to take different images from
a certain structure and also possibility of reconstruction
in sagittal and coronal views, all make CBCT a conve-
nient technology (4-6). The disadvantages of CBCT are its
low resolution of soft tissue and scattering beams from
tooth tissue (6). Usual indications of CBCT in dentistry
are implantation, orthodontic treatments, assessment
of temporomandibular joint (TMJ), relationship of third
mandibular molar with inferior alveolar nerve block and
presence of tumors and cysts (7). Cone-beam computed
tomography makes images by centralizing the X-ray
beam with a conical form on a two-dimensional detec-
tor, which rotates 360 degree around the patients’ head
to make images. Next the algorithm of conical beam is
applied on this data, and thus the technologist can make
reconstructions of the curve and two-planar with differ-
ent thicknesses on each side and achieve clear and actual
three-dimensional images from bone and tooth tissue
(8-10).
According to the significance of CBCT in dental treat-
ments, it seems that assessment of dentists’ awareness
for indications of this system is important. There is only
one research related to this subject which has been done
at Ankara University among dental students (11).
2. Objectives
This study was done to assess the knowledge of dentists
regarding indications of CBCT images during 2012 and
2013 in Qazvin city, Iran.
Tofangchiha M et al.
Biotech Health Sci. 2015;2(1):e258152
3. Materials and Methods
This study received an exemption from the Institutional
Review Board (registration number: 591) of the dentistry
faculty, Qazvin University of Medical Sciences. Out of
124 dentists, who received the self-administered ques-
tionnaires (Figure 1), 100 dentists participated in this
research. The statistical society included both general
dentists and specialists. The questionnaire was designed
considering the studies of Kamburoglu et al. (11), which
were done in two universities in Ankara (4). The question-
naire included demographic data (age, sex, years of em-
ployment, educational degree) and fifteen questions re-
garding the CBCT technology. The questions assessed the
knowledge of dentists about indications of CBCT. There
was no compulsion for answering the questionnaire and
dentists were ensured, that the results of this study will
be used only for educational purposes of the dental soci-
ety and will not be used for evaluating the dentists.
In this pilot survey, analysis of data was done by the SPSS
software version 11.5 (IBM, New York, NY) and Mann-Whit-
ney and Kruskal-Wallis tests.
9. For which of followings, indication of CBCT is not indispensable?
a. Doubt in severe bone resorption
b. Doubt in position of mandibular canal for implantation in the anterior part of lower jaw
c. Doubt in morphology of ridge
d. Doubt in position of mandibular canal for implantation in the posterior part of jaw
2. Which of followings is justifiable for indication of CBCT?
1. A single CBCT examination
a. can be complementary for panoramic views
b. can be prescribed on the basis of patien‘s complaint
c .must be justified for each patient to demonstrate the benefits
outweigh the risks
d. referring for a CBCT practitioner must not supply result and
history of clinical investigations
a. only be used when traditional techniques cannot give new information
b .can be apply without taking clinical examinations
c .CBCT can be used routinely for effective treatments
d. none of the above
10. Orthodontics application of CBCT cannot be for
a. lip cleft
b. palatal cleft
c. impacted canine
d. assessment of airways
3. Which of following specifications for the CBCT compared CT is true?
a. More contrast
b. More cost
c. Higher dose
d. lower accuracy for soft tissue
11. Which of followings in implant surgery is not correct?
a. CBCT images must be taken after clinical examination and conventional radiographies
b. CBCT technique must be applied with minimum dose
c. CBCT is a standard technique for implantation
d. In some cases per apical radiography can be helpful
4. The major indication of CBCT in Iran is for assessment of
a. inferior alveolar nerve block for removing wisdom teeth
b. implant sites
c. pathological lesions
d. bone density
12. Which of followings is not the indication of CBCT?
a. CBCT images can only asses the quantity of bone
b. CBCT images can assess quantity and quality of bone
c. CBCT images can assess the success of bone graft
d. Diagnosis of osteomyelitis
5. For which of following diagnostic imaging tasks, CBCT cannot be used?
a. position of temporomandibular disk
b. position of condyle in glenoid fossa
c. condyle fracture
d. ankylosis
13. CBCT cannot be indicated for
a. impacted mandibular third molars adjacent the mandibular canal
b. alveolar bone assessment in edentulous area for implant placement
c. diagnostic accuracy instead of panoramic view as an alternative technique
d. assessment of condylar erosion
6. Which of followings is not an indication for use of CBCT?
a. assessment of apical cyst
b. soft tissue evaluation
c. sinus evaluation
d. detection of fractures in the posterior part of mandible
14. Intra oral radiographies compare to CBCT are justifiable for
a. interproximal caries
b. measuring the ridge height
c. extension of pathological lesions
d. (a) and (b)
7. Which of following statements regarding CBCT is correct?
a. It can show only vertical root fractures
b. It can show only horizontal root fractures
c. All kinds of root fractures can be detected by CBCT
d. CBCT cannot detect root fractures
15. Which of following orders for prescription is correct? (implantation of 6 and 7
mandibular right teeth)
76
a.
M.PM
b.
tnardauq thgir rewol .C
d. Lower jaw
8. CBCT can be used for evaluating the
a. erosion of TMJ
b. position of disk
c. morphology of disk
d. width of disk
Figure 1. Questionnaire for Evaluation Dentist’s Knowledge Regarding Indications of Cone-Beam Computed Tomography
Tofangchiha M et al.
3
Biotech Health Sci. 2015;2(1):e25815
4. Results
Dentists
̓ relative frequency distribution for demograph-
ic data on the basis of age, gender, number of years for
employment, educational degree, as well as frequency of
distribution on the basis of knowledge are indicated in
Table 1.
Note: Out of 124 questionnaires, which were distributed
among dentists, 100 were answered.
Dentists
̓ relative frequency distribution for the fifteen
questions related to CBCT were as follows: Question 1:
prescribing CBCT: 38 (38%) answers were correct and 62
(62%) were incorrect; Question 2: justifiability for indi-
cations of CBCT: 84 (84%) were correct and 16 (16%) were
incorrect; Question 3: comparing CT and CBCT: 20 (20%)
were correct and 80 (80%) were incorrect; Question 4:
most common indications of CBCT: 83 (83%) were correct
and 17 (17%) were incorrect; Question 5: CBCT and TMJ: 48
(48%) were correct and 52 (52%) were incorrect; Question
6: contraindication of CBCT: 82 (82%) were correct and
18 (18%) were incorrect; Question 7: indication of CBCT
in root fractures: 79 (79%) were correct and 21 (21%) were
incorrect; Question 8: CBCT and articular disc: 47 (47%)
were correct and 53 (53%) were incorrect; Question 9: in-
dication of CBCT for implant surgery in edentulous pa-
tients: 41 (41%) were correct and 59 (59%) were incorrect;
Question 10: contraindication of CBCT in orthodontics:
75 (75%) were correct and 25 (25%) were incorrect; Ques-
tion 11: contraindications of CBCT in implant surgery: 23
(23%) were correct and 77 (77%) were incorrect; Question
12: contra indication of CBCT: 65 (65%) were correct and 35
(35%) were incorrect; Question 13: comparing CBCT with
orthopantomogram (OPG): 57 (57%) were correct and 43
(43%) were incorrect; Question 14: comparing CBCT with
intraoral radiographies, 70 (70%) were correct and 30
(30%) were incorrect; Question 15: order for prescription,
39 (39%) were correct and 61 (61%) were incorrect.
The grading scales for evaluating the level of knowledge
were as follows; 0 - 20 was considered as very low; 20 - 40
was considered as low; 40 - 60 was considered as average;
60 - 80 was considered as high, and 80 - 100 was consid-
ered as very high. Average level of knowledge was 57 ± 17,
lowest mark was 13 and highest mark was 100; 80% had an
average level of awareness.
A P value of < 0.05 obtained from the Kruskal-Wallis test
showed that there was a significant difference between
knowledge of different age groups. Mann-Whitney test
was done for analyzing differences among subgroups; for
less than 30 and 35 to 40 (P = 0.005), for less than 30 and
above 40 (P = 0.021), 30 to 35 and 35 to 40 (P = 0.003), 30
to 35 and above 40 yeas (P = 0.02), there was a significant
difference among subgroups. According to the mean and
median of all groups, awareness was higher in the young-
er age groups. The Pearson’s correlation coefficient was
used for further analysis of these two variables and con-
firmed the relationship between these two variables. Also
r = -0.304 showed a reverse relationship, indicating that
with increasing age there was decreasing knowledge (Ta-
ble 2). The P value obtained from the Mann-Whitney test
showed that there was no significant difference between
knowledge of different genders (Table 3).
The P value of < 0.05 obtained from the Kruskal-Wallis
test showed that there was a significant difference be-
tween knowledge of people with various numbers of
years for employment. Mann-Whitney test was done for
analyzing differences among subgroups; for less than 5
years of occupation and 10 to 15 (P = 0.002), and for less
than 5 years and over 15 years (P = 0.045). According to the
means and medians of all groups, awareness was higher
in groups with lower number of years for employment.
The Pearson’s correlation coefficient was used for further
analysis of these two variables and confirmed the rela-
tionship between these variables. A P value of 0 showed
that there was a relationship and r = -0.326 confirmed a
reverse relationship between the two variables, indicat-
ing that as the number of years of occupation increase,
there is a decrease in knowledge (Table 4). A P value of <
0.05, obtained from the Mann-Whitney test showed that
there was a significant difference between knowledge
and education degree. Means and medians confirmed
that knowledge of specialists was more than general den-
tists (Table 5).
Table 1. Demographic Characteristics of Dentists’ Relative to
Cone-Beam Computed Tomography Knowledge
Characteristic No. (%)
Gender
Male 47 (47%)
Female 53 (53)
Age
Less than 30 years 33 (33)
30 - 35 years 36 (36)
35 - 40 years 11 (11)
Over 40 years 19 (19)
Years for employment
Less than 5 years 54 (54)
5 - 10 years 22 (22)
10 - 15 years 13 (13)
Over 15 years 11 (11)
Educational degree
General 75 (75)
Specialist 25 (25)
Frequency distribution on the basis of knowledge
Very low 4 (4)
Low 16 (16)
Average 50 (50)
High 19 (19)
Very high 11 (11)
Tofangchiha M et al.
Biotech Health Sci. 2015;2(1):e258154
Table 2. Comparison of Knowledge Scores by Age
Age Mean Median Standard Deviation P value
Less than 30 years 61.4 60 18 0.003
30 – 35 years 60.5 53.5 17.7
35 – 40 years 44.3 46 13.4
Over 40 years 49 46 15.9
Table 3. Comparison of Knowledge Scores by Gender
Gender Mean Median Standard Deviation P value
Male 53.1 53.3 15.6 0.06
Female 59.8 60 19.5
Table 4. Comparison of Knowledge Scores According to Number of Years for Employment
Number of Years for Employment Mean Median Standard Deviation P value
Less than 5 years 61.3 60 18 0.008
5 - 10 years 55.4 50 18
10 - 15 years 46 46.6 9
Over 15 years 49 46.6 19
Table 5. Comparison of Knowledge Scores by Educational Degree
Educational Degree Mean Median Standard Deviation P value
General 70.4 73.3 18.6 0.000
Specialist 52.1 46.6 15.4
5. Discussion
This study was done for evaluating dentists’ knowledge
regarding cone beam computed tomography. One hun-
dred dentists including general dentists and specialists
participated in this descriptive cross-sectional study. Fe-
males and those aged 30 to 35 had maximum frequency,
according to frequency distribution. Those aged less than
30 years had the maximum level of knowledge (61.4 %),
and level of knowledge decreased with increase in age.
The inverse relationship between age and knowledge
could be because 1) technology of CBCT has only been
used in the last ten years and 2) the most common usage
of CBCT is for implantation and in Iran young dentists
are more involved in this field. Regarding the level of
knowledge on the basis of gender, no significant differ-
ences were found between males and females. This find-
ing was similar to Kamburoglu’ research that evaluated
dental student’s knowledge for CBCT (11), and assessment
of dentists’ knowledge for prescribing conventional radi-
ographies by Mahdizadeh et al. (12) and Ardakani et al. (5).
Regarding the number of years of employment, there
was a significant difference in the knowledge of individu-
als with different numbers of years of employment; as
the number of years of employment increased awareness
decreased. This was similar to Bardal’s study comparing
dentists that had graduated previously with those that
had recently graduated regarding prescription of intra-
oral radiology and panoramic views (13). According to
level of knowledge on the basis of educational degree,
there was a significant difference between level of knowl-
edge and educational degree; specialist had greater
awareness compared to general dentists. This was similar
to a study done by Mahdizadeh et al. (12), which showed
that specialists had greater knowledge about CT and MRI
compared to other convention intraoral radiographies.
Cone-beam computed tomography has one of the most
important roles for diagnosis in dentistry. This research
showed that dentists in Qazvin city had an average level
of knowledge regarding cone beam CT. It is recommend-
ed that qualification programs must be held for dentists
to increase their awareness toward cone beam computed
tomography. Dentists must gain more knowledge about
indications and contraindications of CBCT.
Acknowledgements
The authors appreciate the financial support of this re-
search by the Research Council of Qazvin University of
Medical Sciences.
Tofangchiha M et al.
5
Biotech Health Sci. 2015;2(1):e25815
Authors’ Contributions
Co-authors helped in designing, analysis of the results
and writing of the current manuscript.
References
1. Bianchi SD, Lojacono A. . 2D and 3D images generated by cone
beam computed tomography (CBCT) for dentomaxillofacial in-
vestigations. CARS. 1998 Amsterdam. Elsevier: pp. 792–7.
2. Ito K, Gomi Y, Sato S, Arai Y, Shinoda K. Clinical application of a
new compact CT system to assess 3-D images for the preopera-
tive treatment planning of implants in the posterior mandible A
case report. Clin Oral Implants Res. 2001;12(5):539–42.
3. Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Do-
simetry of 3 CBCT devices for oral and maxillofacial radiol-
ogy: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol.
2006;35(4):219–26.
4. Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-
beam computed tomography in dental practice. J Can Dent Assoc.
2006;72(1):75–80.
5. Ezoddini Ardakani F, Sarayesh V. Knowledge of Correct Prescrip-
tion of Radiographs among Dentists in Yazd, Iran. J Dent Res Dent
Clin Dent Prospects. 2008;2(3):95–8.
6. Scarfe WC, Farman AG. What is cone-beam CT and how does it
work? Dent Clin North Am. 2008;52(4):707–30.
7. White SC. Cone-beam imaging in dentistry. Health Phys.
2008;95(5):628–37.
8. Feldkamp LA, Davis LC, Kress JW. Practical cone-beam algorithm.
J Opt Soc Am. 1984;1(6):612–9.
9. De Vos W, Casselman J, Swennen GR. Cone-beam computerized
tomography (CBCT) imaging of the oral and maxillofacial re-
gion: a systematic review of the literature. Int J Oral Maxillofac
Surg. 2009;38(6):609–25.
10. White SC, Pharoah MJ. The evolution and application of den-
tal maxillofacial imaging modalities. Dent Clin North Am.
2008;52(4):689–705.
11. Kamburoglu K, Kursun S, Akarslan ZZ. Dental students' knowl-
edge and attitudes towards cone beam computed tomography
in Turkey. Dentomaxillofac Radiol. 2011;40(7):439–43.
12. Mahdizadeh M, Fazaelipour M, Namdari A. Evaluation of den-
tists’ awareness of how to prescribe correct radiographs in Isfa-
han in 2010-2011. J Isfahan Dent Sch. 2012;7(5):637–42.
13. Bardal R, Rahimi R, Ahmadi Motamayel F. A Comparative Study
of the Previously Graduated Dentists' Knowledge versus those
Recently Graduated as to Proper Prescription of Interaoral Ra-
diography and Panoramic Views. J Dent Shiraz Univ Med Univ.
2011;12(3):195–205.
... A study on 100 dental practitioners, both generalists and specialists, was conducted in Iran by [14]. The questionnaire revealed that only 11% and 19% expressed a high level, and a good level of familiarity with CBCT respectively, 50% had moderate knowledge, and 16% and 4% reported low and very low knowledge respectively. ...
... The questionnaire revealed that only 11% and 19% expressed a high level, and a good level of familiarity with CBCT respectively, 50% had moderate knowledge, and 16% and 4% reported low and very low knowledge respectively. The study concluded with the observation that knowledge surrounding CBCT technology amongst dental practitioners was at a moderate level and recommended enhancement through training [14]. ...
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Introduction: Cone-beam computed tomography (CBCT) system is designed to provide 3- dimensional representation of the maxillofacial skeleton with high diagnostic quality of hard tissues of the maxillofacial skeleton. Aim: The aim of the present study was to evaluate the level of knowledge and attitude towards CBCT of orthodontists practicing in two Arab countries in the Middle East. Subject and Method: Data was collected through a questionnaire assessing the knowledge and attitude towards CBCT. Results: A total of 41 participants were enrolled in the study. The most common age group (63%) among participants was more than 40 years old. Knowledge score was calculated as the percent of the right answers from the total of 21 knowledge questions. the distribution of all respondent’s CBCT knowledge revealed that more than three-quarters of the respondents were moderately knowledgeable (76%) whereas 12.2% were in the low and high categories. Conclusion: The study results indicate that there is a definite gap in knowledge and attitude towards CBCT applications amongst the dental specialists. The dental specialists themselves reported lack of training in this field, and strongly urge a need for training in this field.
... A total of 31 papers examined aspects of respondents' knowledge or awareness of CBCT. Of these studies, four appear to have been well-conducted, 10,12,19 15 were moderately robust in their findings, 1,[13][14][15]18,21,23,24,26,27,29,39,41,45,46 and 12 had questionable evidence due to the low strength of their methodology. 16,17,20,22,28,[31][32][33][36][37][38]40,42,43,47 This review found that more than half of dental practitioners have an awareness of CBCT, with 63% to 97% of dentists reporting knowledge of the existence of the imaging technology. ...
... 30 Alternatively, 4%, 16%, 50%, 19% and 11% had very low, medium, good and very good knowledge of indications, respectively. 45 Similarly, a study in Sudan found that only 2.7% of dentists and specialists had very high knowledge, 18.6% had average knowledge, whilst a surprising 54.1% and 20.9% of respondents had low and very low knowledge, respectively. 10 No significant differences in knowledge amongst Sudanese respondents were noted, however specialists demonstrated a higher level of knowledge. ...
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Familiarity with cone beam computed tomography is a requisite for all dental practitioners involved in its use or referral. This scoping review examines the knowledge, attitudes, competence and confidence of dental practitioners and students towards cone beam computed tomography in the dental setting. A search of Medline, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature was conducted to identify and chart existing evidence. Relevant studies written in English and published after 1998 and up to July 2020 were included. Of 679 papers, 39 studies were included for analysis. Key findings include deficient knowledge despite a widespread recognition of its importance and willingness to increase proficiency in its use, as well as a largely positive and optimistic view of the technology. Future studies on practitioners' knowledge and attitudes towards cone beam computed tomography are suggested to consider the contexts of an Australian setting.
... 3 The technology involves imaging a volume that allows either the entire maxillofacial skeleton or a restricted dento-alveolar region involving a few teeth to be imaged. 4 CBCT is indicated for diagnosis and treatment planning in every speciality of dentistry. From nerve tracing in cases of third molar extraction, for implant planning and placement, for maxillofacial surgeries, in sinus pathologies, in endodontics for locating additional roots and accessory canals and in detecting vertical root fracture, orthodontic cases and orthognathic surgeries, in evaluating cysts and tumors, in TMJ disorders, and even used in forensic dentistry. ...
... It is a three dimensional dental and maxillofacial imaging modality. The technology involves imaging a volume that allows either the entire maxillofacial skeleton or a restricted dento-alveolar region involving a few teeth to be imaged [1]. ...
... Cone beam computed tomography (CBCT) is a newly emerging and effective imaging modality for maxillofacial region. [1] It provides an excellent threedimensional visualization of dental hard tissues as well as osseous structures in the oral cavity. [2] With the help of CBCT imaging, the practitioner can limit the anatomical area only to the dentoalveolar arch or may extend to include the entire craniofacial region. ...
... As CBCT is one of the extensively employed imaging modalities that has recently become a useful tool at a work place of dental practice [8][9][10][11]. The present study was conducted among postgraduates of dental specialty of oral medicine and radiology to assess their knowledge on CBCT. ...
... Question 1 was about a single CBCT examination. The questionnaire was adopted from the study done among dentists in Iran [10]. (The questionnaire is available from the corresponding author). ...
... Question 1 was about a single CBCT examination. The questionnaire was adopted from the study done among dentists in Iran [10]. (The questionnaire is available from the corresponding author). ...
... Specialists were showed to be more knowledgeable about CBCT, and gender had no effect on this knowledge. (10) Mehdi Zadeh et al., (11) found that there is a significant difference between the years of graduation and the adequate radiographic orders by increasing the time after graduation and consequently, it may diminished the level of the knowledge. The three-dimensional data of dental structures and related anatomy free of superimpositions helped the dentists to diagnose -14 -sophisticated cases more reliably and plan more beneficial treatments. ...
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Cone beam computed tomography (CBCT), which provides a lower dose, lower cost alternative to conventional CT, is being used with increasing frequency in the practice of oral and maxillofacial radiology. This study provides comparative measurements of effective dose for three commercially available, large (12'') field-of-view (FOV), CBCT units: CB Mercuray, NewTom 3G and i-CAT. Thermoluminescent dosemeters (TLDs) were placed at 24 sites throughout the layers of the head and neck of a tissue-equivalent human skull RANDO phantom. Depending on availability, the 12'' FOV and smaller FOV scanning modes were used with similar phantom positioning geometry for each CBCT unit. Radiation weighted doses to individual organs were summed using 1990 (E(1990)) and proposed 2005 (E(2005 draft)) ICRP tissue weighting factors to calculate two measures of whole-body effective dose. Dose as a multiple of a representative panoramic radiography dose was also calculated. For repeated runs dosimetry was generally reproducible within 2.5%. Calculated doses in microSv [corrected] (E(1990), E(2005 draft)) were NewTom3G (45, 59), i-CAT (135, 193) and CB Mercuray (477, 558). These are 4 to 42 times greater than comparable panoramic examination doses (6.3 microSv [corrected] 13.3 mSv). Reductions in dose were seen with reduction in field size and mA and kV technique factors. CBCT dose varies substantially depending on the device, FOV and selected technique factors. Effective dose detriment is several to many times higher than conventional panoramic imaging and an order of magnitude or more less than reported doses for conventional CT.
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The aim of this study was to evaluate students' knowledge and attitudes regarding cone beam CT (CBCT). A questionnaire consisting of 11 questions was given to 472 dental students (280 pre-graduate and 192 post-graduate) at two institutions located in Ankara, Turkey (Ankara University, Faculty of Dentistry, and Gazi University, Faculty of Dentistry). Differences in responses by institution, education level and sex were statistically assessed with the χ(2) test. Statistical results showed that only 63.3% of students had heard of CBCT. Of these, 59.9% said they had learned about CBCT in their classes, 31.0% in seminars and 20.9% from the internet; 76.8% felt that CBCT was not given adequate coverage in their courses; 69% thought that CBCT should be taught as part of their clinical education; 91% thought it essential for CBCT to be available at dental faculties; 53.5% believed that the use of CBCT would become more widespread in the near future; and 84.9% wished to use CBCT technology in their future careers. This research suggests that efforts should be made to improve students' knowledge base regarding CBCT and that the dental school curriculum should devote more curriculum time to this promising new technology.
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This study reviewed the literature on cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial (OMF) region. A PUBMED search (National Library of Medicine, NCBI; revised 1 December 2007) from 1998 to December 2007 was conducted. This search revealed 375 papers, which were screened in detail. 176 papers were clinically relevant and were analyzed in detail. CBCT is used in OMF surgery and orthodontics for numerous clinical applications, particularly for its low cost, easy accessibility and low radiation compared with multi-slice computerized tomography. The results of this systematic review show that there is a lack of evidence-based data on the radiation dose for CBCT imaging. Terminology and technical device properties and settings were not consistent in the literature. An attempt was made to provide a minimal set of CBCT device-related parameters for dedicated OMF scanners as a guideline for future studies.
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Cone-beam imaging has gained broad acceptance in dentistry in the last 5 years. The purpose of this review is to describe the use in dentistry and consider issues requiring further development. Cone-beam machines emit an x-ray beam shaped liked a cone rather than a fan as in conventional computed tomography (CT) machines. After this beam passes through the patient the remnant beam is captured on an amorphous silicon flat panel or image intensifier/charge-coupled device (CCD) detector. The beam diameter ranges from 4 to 30 cm and exposes the head in one pass around the patient capturing from 160 to 599 basis images. These images are used to compute a volume from which planar or curved reconstructions can be extracted in any orientation. Voxels are isotropic and can be as small as 0.125 mm. 3-D images of bone or soft tissue surfaces can also be generated. In dentistry the most common indications for cone-beam imaging are assessment of the jaws for placement of dental implants, evaluation of the temporomandibular joints for osseous degenerative changes, examination of teeth and facial structures for orthodontic treatment planning, evaluation of the proximity of lower wisdom teeth to the mandibular nerve prior to extraction, and evaluation of teeth and bone for signs of infections, cysts, or tumors. Cone-beam images have largely replaced conventional tomography for these tasks. The effective dose from cone-beam imaging ranges from 6 to 477 microSv. The cost of the equipment is relatively low, about $150,000 to $300,000. Issues to be considered are the training of individuals making and interpreting cone-beam images, as well as means to further reduce patient exposure.
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This article on x-ray cone-beam CT (CBCT) acquisition provides an overview of the fundamental principles of operation of this technology and the influence of geometric and software parameters on image quality and patient radiation dose. Advantages of the CBCT system and a summary of the uses and limitations of the images produced are discussed. All current generations of CBCT systems provide useful diagnostic images. Future enhancements most likely will be directed toward reducing scan time; providing multimodal imaging; improving image fidelity, including soft tissue contrast; and incorporating task-specific protocols to minimize patient dose.
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During the last decades, an exciting new array of imaging modalities, such as digital imaging, CT, MRI, positron emission tomography, and cone-beam CT (CBCT), has provided astounding new images that continually contribute to the accuracy of diagnostic tasks of the maxillofacial region. The most recent, cone-beam imaging, is gaining rapid acceptance in dentistry because it provides cross-sectional imaging that is often a valuable supplement to intraoral and panoramic radiographs. The information content in such examinations is high and the dose and costs are low. The increasing trend toward the use of CBCT in dental offices may be expected to result in improved diagnosis, but with increased patient dose and health care costs. Using CBCT as a secondary imaging tool helps optimize health-to-risk ratio.
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Cone-beam computed tomography (CBCT) systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimetre resolution in images of high diagnostic quality, with short scanning times (10-70 seconds) and radiation dosages reportedly up to 15 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a 3-dimensional representation of the maxillofacial skeleton with minimal distortion. This article provides an overview of currently available maxillofacial CBCT systems and reviews the specific application of various CBCT display modes to clinical dental practice.