Radiographic 3D Imaging: Patient Safety

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

In 2001, CBCT (Cone Beam Computed Tomography) scanners were made available in the United States for dental use. They were expensive and very few dental practices had the ability to invest in this technology. But the advantages of this technology were soon to be made apparent. With the increasing acceptance of implant therapy as a modality to treat edentulism (missing or lost teeth), the popularity of CBCT grew. Traditional dental radiography showed our patients in two dimensions. CBCT, through digital software technology, allowed us to see and manipulate our patients in three dimensions. We now could visualize and locate specific points of anatomy that were essential to the safe and effective placement of implant fixtures. We could calculate whether there was enough bone to support an implant in lateral as well as depth measurements. Also, avoiding important anatomical landmarks like the maxillary sinus or the mandibular nerve/vascular bundle could be appreciated. The technology could be used to diagnose pathology as well as growth and development problems. Since Spring Lake Dental Group invested in this technology, we have used it to benefit our patients in a myriad of applications. The downside of this technology was in its proper use and structure. Ionizing radiation has always been the risk/benefit decision that has to be considered when prescribing the use of this technology. As with other radiographic modalities, CBCT imaging should be used only after a review of the patients health and imaging history and completion of a thorough clinical examination. In accordance with the as low as reasonably achievable(ALARA) principle, radiation dose for dental patients should be optimized to achieve the lowest practical level to address a specific clinical situation. Managing the field of view and using the lowest combination of tube output and scan time are essential parts of managing the risk associated with ionizing radiation. Planmeca, the manufacturer of our CBCT unit has published their Ultra Low Dose protocol. We have trained on this protocol and believe strongly in trying to protect your health but at the same time, utilizing current technology to achieve the greatest outcome

The American Dental Association (ADA) published a Special Issue in August of 2019 on Dental Practice Success: Your Guide to a Healthy Practice in which they laid out the protocols for safe use of CBCT technology. We at Spring Lake Dental Group rely upon this guidance and technology to assist us in providing the kind of care that you have grown to expect through our twenty three years of service to this community!