Cone-beam computed tomography vs conventional radiography in visualization of maxillary impacted-canine localization: A systematic review of comparative studies

Eslami, Ehsan; Barkhordar, H.; Abramovitch, Kenneth; Kim, Jessica; Masoud, Mohamed I.

doi:10.1016/j.ajodo.2016.07.018

Cited by 71 publications

(61 citation statements)

References 38 publications

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“…No que respeita a metade dos médicos dentistas que não pedem CBCT, alguns estudos 6,7 demonstraram que este é mais preciso quando comparado com as técnicas paralaxe horizontais no diagnóstico de posição de caninos maxilares inclusos, sobretudo em casos complexos e não palpáveis. A ausência de CBCT pode acarretar consequências tais como planos de tratamento desadequados ou com mau prognóstico, surpresas indesejáveis, sobretudo no que respeita o grau de dificuldade do caso, dificuldade na exposição cirúrgica e/ou definição do vetor de tração ortodôntica, maior morbilidade do paciente por patologias císticas e reabsorções de dentes vizinhos que passam despercebidas, retalhos mal localizados e técnicas cirúrgicas mais invasivas.…”

Section: Discussionunclassified

“…estudo de imagens de CBCT vs imagens bidimensionais combinadas com telerradiografia de perfil ou radiografias periapicais indicam que a informação do CBCT é superior à obtida por imagens 2D, podendo afetar o plano de tratamento, nomeadamente o estabelecimento da correta via de abordagem cirúrgica no sentido vestíbulo-palatino.De acordo com uma revisão sistemática de 20166 os autores referem que a precisão do CBCT ronda os 50% a 95% e para radiografias convencionais dos 39% aos 85%, pelo que as informações obtidas através destas modalidades são desviantes e, em última análise, podem afetar o plano de tratamento. Tal vai de encontro com o facto de cirurgiões orais correrem menos risco na abordagem cirúrgica de caninos inclusos maxilares, por solicitarem mais vezes exames tridimensionais.…”

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Cirurgia de canino maxilar incluso – O papel dos meios auxiliares imagiológicos e da experiência do operador

Lacerda¹,

Braga²,

Pereira³

et al. 2020

j.rpemd

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r e s u m o informação sobre o artigo Historial do artigo: Recebido a 13 de dezembro de 2018 Aceite a 6 de dezembro de 2019 On-line a 3 de janeiro de 2020 Objetivos: Analisar a via de abordagem cirúrgica, no sentido vestíbulo-palatino, de caninos inclusos maxilares, comparando imagens bidimensionais com tridimensionais (gold standard). A taxa de abordagens corretas foi relacionada com a experiência e especialidade de médicos dentistas, tendo-se ainda avaliado a taxa de pedido de imagens tridimensionais para estudo destes casos. Métodos: A amostra foi constituída por 80 médicos dentistas inscritos na Ordem dos Médicos Dentistas, que voluntariamente aceitaram responder a um questionário constituído por radiografias panorâmicas e telerradiografias de trinta caninos maxilares inclusos. Todos os casos apresentavam tomografia computorizada de feixe cónico (CBCT) analisada por dois cirurgiões orais, que definiram a abordagem cirúrgica mais exata (gold standard) no sentido vestíbulo-palatino para cada canino. Tal serviu para confirmar ou refutar as escolhas das abordagens feitas nos questionários. Resultados: Não parece existir relação entre a taxa de abordagens corretas e a experiência, porém foi encontrada quanto à especialidade, com os cirurgiões orais a escolheram mais vezes a via de abordagem correta do que generalistas (p=0,034). Não foram encontradas diferenças entre as restantes especialidades (p>0,05). Existe associação entre a especialidade e o pedido de CBCT (p=0,008), sendo mais provável que cirurgiões peçam sempre. Conclusão: Com base nos dados obtidos neste estudo verificou-se a existência de uma relação entre a especialidade do Medico Dentista (Cirurgia Oral), o número de abordagens cirúrgicas corretas de caninos maxilares inclusos e o pedido de exames complementares de

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Section: Discussionunclassified

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Cirurgia de canino maxilar incluso – O papel dos meios auxiliares imagiológicos e da experiência do operador

Lacerda¹,

Braga²,

Pereira³

et al. 2020

j.rpemd

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“…The use of CBCT in dental orthopedics may influence the treatment planning and diagnostic capabilities although there is no strong evidence for improvements in patient outcome associated with the use of 3D imaging techniques. The CBCT examination is likely indicated for diagnosis of dental anomalies in the clinical circumstances that require three‐dimensional assessment of dental or bone morphology and for which the benefits oversights the potential risk of exposure.…”

Section: Introductionmentioning

confidence: 99%

Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D

Marcu

Hedeșiu

Salmon

et al. 2018

Int J Paed Dentistry

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“…Authors' response W e thank Dr Webb for his comments on our article (Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. Am J Orthod Dentofacial Orthop 2018;154: [15][16][17][18][19][20][21][22][23][24][25]. Because his was a very detailed and well-supported opinion, we felt the need to respond in kind.…”

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confidence: 99%

“…CBCT can alter treatment planning decisions for patients with impacted maxillary canines. 20,[23][24][25] However, an impacted canine in clinical practice is usually discovered after acquisition of a 2D image, usually a panoramic radiograph. Furthermore, the reference by Ludlow et al 11 had no discussion about CBCT and merely suggested that the effective doses of common 2D intraoral and extraoral imaging techniques warrant reconsideration of means to reduce patients' exposure.…”

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confidence: 99%

Authors' response

Abdelkarim

2018

American Journal of Orthodontics and Dentofacial Orthopedics

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publications. Updated studies with recommendations based on the use of ULD CBCT technology vs 2D radiographic techniques would be beneficial. 3. CBCT scans with lower effective doses (ULD) inherently have lower resolution and thus lower image quality than higher resolution scans. Although high-resolution scans may be required for certain periodontic, endodontic, or oral surgical procedures, the quality of ULD CBCT scans is diagnostically acceptable for orthodontic purposes (ALADA) and is improving as the technology advances. 6 4. Concerns over the interpretation of CBCT scans taken for orthodontic diagnostic purposes continue, and the authors have reviewed these in detail. The interpretation of intraoral radiographs has been included in dental school curricula for more than half a century. Today, the interpretation of digital 2D intraoral and panoramic radiographs is taught in dental school. The interpretation and analysis of cephalometric radiographs (lateral and anteroposterior) are taught in our orthodontic residencies. At the 2017 American Association of Orthodontists' Winter Conference in Fort Lauderdale, Chris Bentson reported on a survey of recent (2016) orthodontic residency graduates in the United States: 88% responded that they had used CBCT imaging for diagnosis and treatment planning during their residencies. In my opinion, as ULD CBCT imaging becomes more common in orthodontics, just as it has become more common in orthodontic residency programs, the interpretation and analysis of CBCT scans must become part of orthodontic residency curricula. The availability of continuing education courses on this subject must also increase. Dental education has evolved with advances in technology, and the education in our specialty must evolve as well. The authors' conclusions are well thought out and concise. I agree with them fully, with 1 exception. "4. Consider CBCT imaging only when it is expected to yield a benefit to the patient or change the outcome of treatment over 2D radiographs." When exposure protocols (FOV, voxel size, scan time) are tailored to diagnostic needs, the current generation of ULD CBCT scanners can provide an immediate benefit-more diagnostic information with an effective dose equal to or less than 2D radiographs. My conclusion would be that CBCT imaging is acceptable for radiographic acquisition when its effective dose is less than or equal to comparable FOV 2D radiographs, or when it is expected to yield a benefit to the patient or change the outcome of treatment over 2D radiographs.

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Cone-beam computed tomography vs conventional radiography in visualization of maxillary impacted-canine localization: A systematic review of comparative studies

Cited by 71 publications

References 38 publications

Cirurgia de canino maxilar incluso – O papel dos meios auxiliares imagiológicos e da experiência do operador

Cirurgia de canino maxilar incluso – O papel dos meios auxiliares imagiológicos e da experiência do operador

Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D

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