ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Cone-Beam Computed Tomography (CBCT) Use in Routine Orthodontic Evaluation Exposes Patients to Higher Levels of Radiation Than Lateral Cephalometric Radiography and/or Digital Panoramic Radiography
Clinical Question Is there a significant increase in radiation exposure for individuals undergoing routine orthodontic evaluation when Cone-Beam Computed Tomography is used as opposed to lateral cephalometric radiography and/or digital panoramic radiography?
Clinical Bottom Line Cone-Beam Computed Tomography use in routine orthodontic evaluation exposes patients to higher levels of radiation than lateral cephalometric radiography and/or digital panoramic radiography. This has been demonstrated by two comparative studies that utilized radiation sensors in anthropomorphic phantoms to measure the effective radiation doses of each imaging method. In each study, it was shown that the use of Cone-Beam Computed Tomography results in a significantly larger effective radiation dose to the patient than traditional cephalometric and/or digital panoramic radiography.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22464525Grunheid/2012Head and neck phantomLaboratory
Key resultsIn this comparative study, the effective radiation doses for several orthodontic imaging methods were examined. It was found that lateral cephalometric radiography and digital panoramic radiography exposed patients to the lowest effective radiation doses (4.5 μSv and 21.5 μSv, respectively.) One Cone-Beam Computed Tomography device (i-CAT) was likewise assessed using various settings. The effective radiation doses for the i-CAT unit ranged from 64.7 μSv to 134.2 μSv depending on the voxel size, resolution, and field-of-view setting.
#2) 18456133Silva/2008Anthropomorphic phantomLaboratory
Key resultsIn this comparative study, the effective radiation doses for several orthodontic imaging methods were examined. It was found that panoramic/lateral cephalometric radiography had the lowest effective radiation dose (10.4 μSv). Two Cone-Beam Computed Tomography devices (i-CAT and NewTom 9000) were likewise assessed and had effective radiation doses of 61.1 μSv and 56.2 μSv, respectively. Multi-slice CT imaging had the highest effective radiation dose (429.7 μSv).
Evidence Search "Cone-Beam Computed Tomography/instrumentation"[Mesh] AND "Radiography, Panoramic"[Mesh] AND "Cephalometry"[Mesh] AND "Radiation Dosage"[Mesh]
Comments on
The Evidence
Each study used an anthropomorphic phantom and thermoluminescent dosimeters. Neither study mentioned the presence or absence of competing interests
Applicability The use of Cone-Beam Computed Tomography in routine orthodontic evaluations exposes patients to higher levels of radiation than do traditional lateral cephalometric and digital panoramic radiographic techniques. Use of Cone-Beam Computed Tomography in uncomplicated orthodontic cases may therefore not be warranted, especially in patients who, for medical or personal reasons, are concerned by the increased levels of radiation exposure. In most cases, the use of lateral cephalometric and digital panoramic radiographs will provide a comparatively safe and sufficient alternative to Cone-Beam Computed Tomography for use in orthodontic diagnosis and treatment planning.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Orthodontics)
Keywords Cone beam computed tomography, cephalometric imaging, Radiation, Orthodontics, Radiology
ID# 2673
Date of submission: 03/25/2014spacer
E-mail flandersb@livemail.uthscsa.edu
Author Bethany Flanders
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Birgit J. Glass, DDS, MS
Faculty mentor/Co-author e-mail glass@uthscsa.edu
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