UBC Theses and Dissertations
The use of cone beam computed tomography for implant treatment planning at UBC Hans, Amandeep
Purpose: Cone beam computed tomography (CBCT) has become the standard of care for many applications in the specialty of periodontics. CBCT is now taken for almost all implant related cases and there is also a clear shift towards higher resolution images. However, the increased radiation dosage from a higher resolution images must be accompanied by valid clinical justification. Aims: The first aim was to conduct an audit of all CBCT prescriptions at the UBC Faculty of Dentistry with a focus on implant related prescriptions. Concurrently, all implant related prescriptions were evaluated for compliance with the current guidelines. The second aim was to evaluate whether altering the mA and kVp values will result in measurement differences on CBCT images. Materials and Methods: Ethics approval was granted for the retrospective portion of this study (Certificates H18-01536 and H19-02001). All CBCT prescriptions were audited from Jan. 1, 2015 to Aug. 31, 2018. However, the prescriptions originating from the Graduate Periodontics and Prosthodontics programs were examined more thoroughly. A major finding from the audit was a shift towards higher resolution images for the small FOV. An in vitro experiment was conducted to determine whether changing the imaging parameters and scatter would affect the measured distance between two adjacent implants placed in a model. Results: Almost all the CBCT scans prescribed in the Periodontics and Prosthodontics departments were prescribed for the purposes of implant treatment planning. In Graduate Periodontics and Prosthodontics, 95% and 94% of the prescriptions, respectively, were compliant with the guidelines published by the AAOMR and the AAP. Manipulation of the imaging parameters did affect the measured distance between the two implants when specific mA and kVp values were compared. The scatter and metal artifacts from the addition of a third implant did not have any effect on the measured distance. Conclusion: CBCT was used judiciously for implant treatment planning in both the Graduate Periodontics and Prosthodontics department. Manipulation of CBCT parameters had a statistically significant effect on the measured distance between two adjacent implants but the potential scatter and metal artifacts from the addition of third implant did not.
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