Radiation doses in examination of lower third molars with computed tomography and conventional radiography

Öhman, Anders; Kull, Love; Andersson, Jonas; Flygare, Lennart

doi:10.1259/dmfr/86360042

Cited by 25 publications

(13 citation statements)

References 12 publications

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“…27,28 Consequently, CBCT has, in most cases, taken over the role of medical CT in dentistry. The radiation dose for an examination of a mandibular third molar is higher for medical CT scanning than with PAN imaging, PA and SCAN, 29 and although CBCT might provide lower radiation doses to the patient than medical CT, the dose is still higher for most CBCT units than for PAN imaging etc. 28,30,31 Apart from the parameters that influence the quality of two-dimensional (2D) images, such as the examined object, tube voltage, amperage and spatial resolution, the image quality of CBCT images is also influenced by the scanned tissue volume, the so-called field of view (FOV) and the resolution defined by the voxel size.…”

Section: Cbct Scanningmentioning

confidence: 99%

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Matzen

Wenzel²

2015

Dentomaxillofacial Radiology

114

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A radiographic examination of mandibular third molars is meant to support the surgeon in establishing a treatment plan. For years panoramic (PAN) imaging has been the first choice method; however, where an overprojection is observed between the third molar and the mandibular canal and when specific signs suggest a close contact between the molar and the canal, CBCT may be indicated. The present review provides an evaluation of the efficacy of CBCT for assessment of mandibular third molars using a six-tiered hierarchical model by Fryback and Thornbury in 1991. Levels 1-3 include studies on low evidence levels mainly regarding the technical capabilities of a radiographic method and the diagnostic accuracy of the related images. Levels 4-6 include studies on a higher level of evidence and assess the diagnostic impact of a radiographic method on the treatment of the patient in addition to the outcome for the patient and society including cost calculations. Only very few high-evidence studies on the efficacy of CBCT for radiographic examination of mandibular third molars exist and, in conclusion, periapical or PAN examination is sufficient in most cases before removal of mandibular third molars. However, CBCT may be suggested when one or more signs for a close contact between the tooth and the canal are present in the two-dimensional image-if it is believed that CBCT will change the treatment or the treatment outcome for the patient. Further research on high-evidence levels is needed. Dentomaxillofacial Radiology (

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Section: Cbct Scanningmentioning

confidence: 99%

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Matzen

Wenzel²

2015

Dentomaxillofacial Radiology

114

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“…effective doses (ICRP 2007) of the different imaging techniques are reported as follows: CBCT, 13-1,073 μSv [3, 5, 74]; Panoramic radiography, 8.6-24.3 μSv [4, 75, 76]; PA cephalometric radiography, 2.3-5.1 μSv [4, 77]; intraoral radiography, 0.3-5.5 μSv [4, 75]; and head CT, 470-4,000 μSv[73,74,76,78] …”

mentioning

confidence: 99%

Necessity of 3D visualization for the removal of lower wisdom teeth: required sample size to prove non-inferiority of panoramic radiography compared to CBCT

2011

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The availability of cone beam computed tomography (CBCT) and the numbers of CBCT scans rise constantly, increasing the radiation burden to the patient. A growing discussion is noticeable if a CBCT scan prior to the surgical removal of wisdom teeth may be indicated. We aimed to confirm non-inferiority with respect to damage of the inferior alveolar nerve in patients diagnosed by panoramic radiography compared to CBCT in a prospective randomized controlled multicentre trial. Sample size (number of required third molar removals) was calculated for the study and control groups as 183,474 comparing temporary and 649,036 comparing permanent neurosensory disturbances of the inferior alveolar nerve. Modifying parameter values resulted in sample sizes ranging from 39,584 to 245,724 respectively 140,024 to 869,250. To conduct a clinical study to prove a potential benefit from CBCT scans prior to surgical removal of lower wisdom teeth with respect to the most important parameter, i.e., nerval damage, is almost impossible due to the very large sample sizes required. This fact vice versa indicates that CBCT scans should only be performed in high risk wisdom tooth removals.

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“…Many researchers do not include the calvaria [6, 8, 15, 18–24] and cervical vertebrae [18, 21, 23, 24] when counting the red bone marrow, esophagus [8, 18–21, 23–26], skin [25], and remaining tissues in the calculation of the effective dose [6, 18, 19, 21, 23, 24]. The ICRP version used is important due to the inherent variations in the different weighting factors.…”

Section: Discussionmentioning

confidence: 99%

Cone-Beam Computed Tomography and Radiographs in Dentistry: Aspects Related to Radiation Dose

Lorenzoni

Bolognese

Garib³

et al. 2012

International Journal of Dentistry

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Introduction. The aim of this study was to discuss the radiation doses associated with plain radiographs, cone-beam computed tomography (CBCT), and conventional computed tomography (CT) in dentistry, with a special focus on orthodontics. Methods. A systematic search for articles was realized by MEDLINE from 1997–March 2011. Results. Twenty-seven articles met the established criteria. The data of these papers were grouped in a table and discussed. Conclusions. Increases in kV, mA, exposure time, and field of view (FOV) increase the radiation dose. The dose for CT is greater than other modalities. When the full-mouth series (FMX) is performed with round collimation, the orthodontic radiographs transmit higher dose than most of the large FOV CBCT, but it can be reduced if used rectangular collimation, showing lower effective dose than large FOV CBCT. Despite the image quality, the CBCT does not replace the FMX. In addition to the radiation dose, image quality and diagnostic needs should be strongly taken into account.

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Radiation doses in examination of lower third molars with computed tomography and conventional radiography

Cited by 25 publications

References 12 publications

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Necessity of 3D visualization for the removal of lower wisdom teeth: required sample size to prove non-inferiority of panoramic radiography compared to CBCT

Cone-Beam Computed Tomography and Radiographs in Dentistry: Aspects Related to Radiation Dose

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