Guidelines for clinical use of CBCT: a review

Abstract

Objectives: To identify guidelines on the clinical use of CBCT in dental and maxillofacial radiology, in particular selection criteria, to consider how they were produced, to appraise their quality objectively and to compare their recommendations. Methods: A literature search using MEDLINE (Ovid ® ) was undertaken prospectively from 1 January 2000 to identify published material classifiable as "guidelines" pertaining to the use of CBCT in dentistry. This was supplemented by searches on websites, an internet search engine, hand searching of theses and by information from personal contacts. Quality assessment of publications was performed using the AGREE II instrument. Publications were examined for areas of agreement and disagreement. Results: 26 publications were identified, 11 of which were specifically written to give guidelines on the clinical use of CBCT and contained sections on selection criteria. The remainder were a heterogeneous mixture of publications that included guidelines relating to CBCT. Two had used a formal evidence-based approach for guideline development and two used consensus methods. The quality of publications was frequently low as assessed using AGREE II, with many lacking evidence of adequate methodology. There was broad agreement between publications on clinical use, apart from treatment planning, in implant dentistry. Conclusions: Reporting of guideline development is often poorly presented. Guideline development panels should aim to perform and report their work using the AGREE II instrument as a template to raise standards and avoid the risk of suspicions of bias.

Dose optimization by altering the operating potential and tube current exposure time product in dental cone beam CT: a systematic review

“…1 Dental CBCT is still a relatively new imaging technology, but the volume of research related to this imaging technology has grown steadily over the past decade. 2,3 Guideline documents, recently reviewed by Horner et al(2015), 4 have been devised at local, national and supranational levels to assist dentists, radiologists, radiographers/technologists and medical physicists in safe use of CBCT; some of these give general guidance on optimization, although detail is absent. For example, the European guidelines 5 state, "X-ray tube voltage and tube current-exposure time product should be adjustable on CBCT equipment and must be optimised during use according to the clinical purpose of the examination…"; however, there is no specific instruction on how optimization is to be achieved in practice.…”

Methodological Quality of Consensus Guidelines in Implant Dentistry

“…Horner et al [9] recently evaluated 26 guidelines on the use of cone-beam computerised tomography in dental and maxillofacial radiology using the AGREE II instrument. As in the present analysis, they obtained good scores for domain 1 (scope and purpose) and very poor scores for domain 5 (applicability) [9].…”

“…Horner et al [9] recently evaluated 26 guidelines on the use of cone-beam computerised tomography in dental and maxillofacial radiology using the AGREE II instrument. As in the present analysis, they obtained good scores for domain 1 (scope and purpose) and very poor scores for domain 5 (applicability) [9]. San Martin-Galindo et al [10] used the AGREE II tool to evaluate three guidelines on the use of pit and fissure sealants for dental clinicians; scores for domain 6 (editorial independence) were lowest.…”

A Full‐Digital Technique to Mount a Maxillary Arch Scan on a Virtual Articulator

“…The limitation of this method could be the need for a CBCT with a FOV containing the maxilla and external ear canals. Keeping with the ALARA principle (radiation exposure to the patient should be as low as reasonably achievable), it is not justifiable to apply this technique in simple prosthodontic or orthodontic cases . The indication of the present technique could be orthognathic surgeries, complex interdisciplinary (i.e., orthodontic, prosthetic, implant, and TMJ) cases that need a CBCT scan with a large FOV, or patients who already have the head 3D radiograph from previous diagnosis/treatment (Fig ) …”