Applications of cone beam computed tomography for a prosthodontist

Abstract

Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.

Keywords: Applications; cone beam computed tomography; implant; prosthodontics; temporomandibular joint.

Figure 1

(a) Three-dimensional view of three implants in the right maxillary posterior region; GALAXIS GALILEOS viewer 1.9 software in SIRONA ORTHOPHOS XG 3D, permits the image to be viewed in all directions/probable angles, demonstrating the proximity to important vital structures. (b) The same three implants in a tangential view. (c) Cross-sectional view showing relationship of implant to the floor of the maxillary sinus

Figure 2

(a) Three-dimensional view of the fractured head of a condyle. The image also demonstrates the glenoid fossa, styloid process, and medial aspect of the mandibular ramus. (b) Cross-sectional view of the fractured condylar head

Figure 3

Airway zones (green) divided into nasal, nasopharyngeal, and oral airways; supported posteriorly by the spine, superiorly by the cranial base, and anteriorly by the maxilla, mandible and hyoid (cream). Mobile elements associated with airway – tongue, soft palate, and epiglottis (orange)