1887

Better dental imaging: techniques and practice

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Abstract

: Cone-beam CT offers three significant advantages over conventional intraoral radiography. The first relates to the speed with which images are captured; the patient’s entire head is imaged in a 30-second time frame. With conventional intraoral radiography, a full-mouth series can be acquired in 6-10 minutes in the most experienced hands, and as long as 30 minutes for less experienced staff members. The second, most important advantage of CBCT is the ability to visualize structures that are difficult to evaluate on conventional radiographs. These include the maxillary molar teeth, the palatal root of the maxillary 4th premolar tooth, and rotated maxillary and mandibular premolar teeth in brachycephalic dogs and cats. In addition, CBCT allows evaluation of the nasal cavity, maxillary recess, frontal sinuses, TM joints, and tympanic bullae. Finally, use of specialized software to create 3D reconstructive images of the patient’s skull allows clinicians to better visualize the patient’s overall maxillofacial and dental structures and aids client education efforts. While CBCT is commonly employed to evaluate cases with maxillofacial trauma or neoplasia, we have found it extremely useful for every day periodontal and endodontic cases as well.

: For two-rooted teeth we can often get good conclusive radiographs using parallel technique or bisecting angle technique when obtaining pictures, but for the three rooted maxillary teeth (especially fourth premolar and first molar), getting a conclusive diagnosis from dental radiographs can prove to be more challenging. This lecture presents the projections needed to obtain good pictures of both teeth, introducing a totally new projection that is very helpful to evaluate attachment loss and periapical pathology.

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