3D Imaging with our CBCT
At Southern New Hampshire Endodontics, our goal is to provide our patients with the highest level of endodontic care possible and that includes true-to-life, 3D imaging made possible with cone beam CT technology (CBCT). The CS 8100 3D is Carestream’s latest system and is capable of capturing both 3D and 2D images. It delivers an accurate view of patients’ teeth and jaw anatomy for improved diagnoses and treatment planning and allows for viewing a tooth from every angle, with exact scale accuracy and without distortion or overlap of anatomy. Plus, because it’s digital, images are available for viewing within seconds and can be safely stored in patients’ records.
Not every situation requires a 3D scan and conventional 2-dimensional images will suffice much of the time. However, sometimes the anatomy of a tooth can be stunningly complex and there is obvious advantage for a dentist to be able to know these intricacies through 3D visualization. Clearly the goal of saving a tooth is facilitated by this knowledge. Just a few of the challenging situations include:
- to determine definitively whether a tooth has an extra canal or root, which could not be located clinically; the system has a measuring function which then assists in its location, if one is present
- to locate a canal which has filled in with calcification over the years, to increase the chances of doing a complete root canal
- to determine the problem areas when a patient presents with an old, infected root canal, which allows for a more precise treatment plan and improves the prospects for a solution
- to look for cracks and fractures
- to map out and determine the extent of root resorption; many teeth with this problem are extracted because the affected area sometimes looks worse than it actually is and on the other hand sometimes substantial treatment time will be spent trying to save a tooth with this problem when a 3D scan would have demonstrated extraction was the better alternative.
These are just a few of the applications when a 3D scan provides an extra advantage in efforts to save a tooth. And of tremendous benefit to a patient is that sometimes the information attained from the scan will indicate a tooth can’t be saved at all, without having to spend a long visit and substantial costs of actually having to work on the tooth to determine the same outcome.
In addition, a 3D scan allows for the opportunity to detect other issues. In the December 2018 issue of the Journal of the American Dental Association, in an article titled Ameloblastoma incidentally detected in cone-beam computed tomography sialography, it was reported, “Cone-beam computerized tomographic (CBCT) imaging is increasingly used in the maxillofacial region for various purposes. The volumetric dataset created by means of CBCT increases the possibility of detecting incidental findings”.
Carestream has designed the CS 8100 with safety in mind and especially because we are studying a very limited area, the amount of radiation a patient is exposed to is typically in a range between the amount of natural, background exposure that occurs to all of us on a daily basis and that which occurs when we fly from coast to coast. And with the cost of replacing a tooth with an extraction-implant-crown often times approaching several thousand dollars, it usually is desirable to save one’s tooth whenever it is feasible. With the cost of a 3D scan being around a couple hundred dollars it makes great sense to take advantage of this newest technology whenever it is deemed useful.
RESEARCH REGARDING CBCT USE, AS REPORTED IN THE JOURNAL OF ENDODONTICS:
July 2018: CBCT was the best method for the detection of external root resorption defects. The aim of this study was to compare the sensitivity and specificity of conventional radiographs and CBCT….
February 2018: … when dealing with external cervical resorption, treatment plans developed with PA radiographs differed from those developed wit CBCT images in the majority of cases.
January 2018: …The advantages of CBCT scanning (when investigating root canal morphology) are its high accuracy, minimal distortion, and 3D visualization. Moreover, it is a non-destructive technique and can provide specific data.
October 2017: … taking a CBCT scan when an MB2 canal is not found clinically can significantly increase the chances of finding an MB2 canal.
September 2017: … a preoperative CBCT image provides more information than a preoperative pa radiograph and that this information can directly influence retreatment strategies.
September 2017: … the CBCT proved to be a reliable tool for the identification of the mandibular second molar C-shaped morphology …
September 2017: …this study shows that CBCT imaging can be used to assess dentin wall thickness accurately.