Clinical Application Of Cone Beam Computed Tomography In Diagnosis And Treatment Planning In Oral&Maxillofacial Region

Objective: To evaluate CBCT’s value in assistant diagnose and guiding treatmentplan of some dental clinical difficulty miscellaneous diseases. To learn CBCT’sadvantage in assistant diagnose and treatment of dental clinical diseases throughinvestigation and analysis on clinical cases, observing their images with CBCT andfollowing up closely, making contrastive analysis with the traditional x-ray image,thus providing some reliable information for CBCT’s clinical application.Methods: Normal x-ray examination and CBCT examination in125cases from May,2010to March2012in Guangzhou overseas Chinese Hospital were made contrastiveanalysis after routine examination. There are5cases of bone island，7cases ofperi-implantitis,13cases of periodontitis,10cases of root canal retreatment teeth,40cases of periapical periodontitis,30cases of the embedded teeth, and20cases offracture in total, which were aged from10to81years old，43years old on average.All the cases were respectively diagnosed by three high year physicians，a radiationcompetent technicians and the researcher.Results：(1)Bone Island patients through the CBCT image analysis can initiallydetermine the location and range of the bone island;(2) There was no significantdifference in medial-distal orientation(P>0.05)，while significant difference in thejudgment of the alveolar bone defects in lingual-buccal orientation (P<0.05)。CBCTnot only to early diagnosis of disease occurrence，but also be observed from thethree-dimensional direction of the surrounding alveolar bone changes ofperi-implantitis or periodontitis。(3)In10cases of dental pulp disease who still feltuncomfortable after RCT, the etiology could be ascertained by CBCT with100percent accuracy. In40cases of periapical periodontitis, through sagittal and coronalCBCT examination, slant-crack could be indentified clearly, the location and typescould be confirmed, thus some periapical periodontitis could be found while normal x-ray could not。(4) Patients with embedded teeth by CBCT could clearly show thelower and upper jaws with the adjacent structures, the exact locality, number, size,shape, adjacent area of the embedded teeth，and their relationship with other root.There was significant difference in determining the exact location of the embeddedtooth（P<0.05）。(5)Fractured patients through the CBCT3D image reconstruction andform a spiral CT are basically the same。Ask client to images are a clear display theexact type and location of the fracture。CBCT sensitivity in the detection of fracturesis higher than traditional X-ray。Conclusions:1.CBCT can provide high resolution3D image information, jaw’s finestructure reconstruction and imaging, clearly showed the lesion extend and range;2.CBCT is applied to the early diagnosis peri-implantitis and periodontitis occurrence,and shows the extent of the lesion;3.CBCT can earlier found dental pulpal andperiapical disease, guide the treatment and therapeutic efficacy evaluation;4.CBCTcan clear and visual reproduce location of the impaction teeth and relationship withthe adjacent teeth;5.Three-dimensional reconstruction can show the fracture linedirection, location, type and fracture plate movement, can reduce the chance ofmisdiagnosis and missed diagnosis of complicated fracture.