{"id":29671,"date":"2022-03-25T14:02:52","date_gmt":"2022-03-25T14:02:52","guid":{"rendered":"http:\/\/tvp.tv-multi-theme.com.216-70-96-51.jvv2-rfnp.accessdomain.com\/?p=29671"},"modified":"2022-03-30T19:20:15","modified_gmt":"2022-03-30T19:20:15","slug":"cone-beam-computed-tomography-in-veterinary-dentistry","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/cone-beam-computed-tomography-in-veterinary-dentistry\/","title":{"rendered":"Cone Beam Computed Tomography in Veterinary Dentistry"},"content":{"rendered":"

Cone beam computed tomography (CBCT) is a useful tool for 3-dimensional (3-D) evaluation of the dentoalveolar and maxillofacial structures in canine and feline patients. A single scan produces a wide variety of angles and views of structures in the maxillofacial region, useful for treatment planning for patients that have endodontic disease or need to undergo oncologic or trauma surgery.\u00a0<\/span><\/span><\/p>\n

Although CBCT has been available in human dentistry for many years, it is new to the veterinary field. Many veterinary dentists have started using CBCT technology, and in some cases, general practitioners can also benefit from its use in the treatment of maxillofacial disease. This article is intended to introduce CBCT to the general practitioner and to provide an understanding of the technology available on a referral basis.<\/span><\/p>\n

What is Cone Beam Computed Tomography?<\/h2>\n

CBCT is a type of 3-D imaging that uses radiation, similar to conventional computed tomography (CT). However, with conventional CT the x-ray beam is in the shape of a fan, and with CBCT the beam is in the shape of a cone.\u00a0<\/span><\/span><\/p>\n

The cone is designed to be the size of the area of interest and originates from a flat x-ray generator. CBCT uses the cone-shaped beam to encompass the area of interest, and the x-ray source makes only 1 pass around the patient to acquire all the data needed for the image. A sensor located on the opposite side of the patient collects the information (<\/span>FIGURE 1<\/span><\/strong>). The average dose of radiation to the canine or feline patient with a single CBCT scan is similar to that of a thoracic radiograph. Because of its compact design and low radiation, CBCT is more readily available than conventional CT and is perfect for imaging the maxillofacial area.<\/span><\/p>\n

The maxillofacial region is a complicated area of the body. Canine and feline skulls have an average of 50\u00a0bones in a very complex 3-D arrangement. The typical adult dog has 42 teeth and the typical adult cat, 30 teeth. The sinuses are filled with turbinates, which are radiopaque. The upper and lower jaw contact each other inside the temporomandibular joint. All these factors create significant overlap and confusion in the interpretation of the images of head and dental structures. The 3-D images produced by CBCT help clarify the locations of maxillofacial structures and enable more appropriate interpretation of pathology.<\/span><\/p>\n

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Figure 1. Working area of a cone beam computed tomography system. The x-ray generator and a flat collection plate are on opposite sides of the patient. The machine makes a single rotation around the patient to collect the data.<\/p><\/div>\n

What Other Imaging Modalities are Used for Maxillofacial Imaging?<\/h2>\n

Skull radiographs<\/b> are the easiest images to obtain. However, due to the complicated arrangement of bone, joint, and dental structures, skull radiographs are the most difficult to interpret and have the lowest diagnostic yield. The overlapping structures make it very easy to overinterpret suspected abnormalities and overlook true abnormalities.\u00a0<\/span><\/span><\/p>\n

Conventional and helical CT<\/b> scanners provide 3-D images. With conventional CT, the x-rays are generated from a high-output rotating x-ray anode tube. Images are captured at different levels of the patient in individual slices as the patient moves in increments through the machine. Over time, most conventional CT scanners have been replaced by helical (spiral) CT scanners (<\/span>FIGURE 2<\/span><\/strong>), for which a circular generator rotates as the patient moves through the unit, creating images in a spiral fashion. The images must overlap slightly and are reconstructed by the computer into a 3-D image.\u00a0<\/span><\/span><\/p>\n

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Figure 2. Helical computed tomography system that requires movement of the patient through the x-ray beam.<\/p><\/div>\n

Dental (intraoral) radiographs<\/b> are the gold standard for evaluating dentition and the bone around the teeth. Because the x-ray sensor is placed in the mouth and the x-rays are very focused, the teeth and bone around the teeth can be easily visualized with minimal overlap of other structures. For dental cleaning procedures, dental radiographs are often used to evaluate the root structure and health of the teeth, both inside (endodontic) and outside (periodontal). Among other things, dental radiographs enable evaluation of the teeth to determine:<\/span><\/p>\n