Research On Cone Beam Computed Tomography

The video shows how parts of a cone beam computed tomography (CBCT) scan can be isolated and manipulated. More or less in real time, at a well equipped clinic.

There is no need to travel, exposure time, radiation dose and cost compare well to other imaging techniques. This has led researchers and professional bodies to state that CBCT is now the gold standard for maxillofacial care.

Others would say that MRI scans are still better for certain conditions and we wouldn’t disagree. The differential is not always understood, as recent research shows.

The Temporomandibular Joint

A number of problems can affect this joint, from dislocation to trauma. Temporomandibular joint osteoarthritis is also a possibility and needs careful diagnosis.

MRI scans tend to be seen as the best route, so in a paper published in May 2023, a team set out to compare their effectiveness to CBCT.

CBCT proved to be about 40% more accurate, not least regarding erosion and flattening. The study concluded that MRI’s greater value in this case was a myth, with CBCT superior to MRI in evaluating osseous changes.

There is no rational reason to feel that the performance would not be reflected in other areas. Similar results have been seen for a range of hard tissues, although not always for soft tissue.

An Improving Tool

Rather than hard tissue, a similar study to the one above looked at using MRI or CBCT to assess the soft tissue of the mandibular nerve. MRI was found to be more effective, although there is a caveat.

This research was carried out over a decade ago, in 2012. Since then, there have been significant software advances, to improve signal to noise ratio on CBCT scans and increase visual contrast.

By 2018, researchers were adopting a different tone. A few years later, research to compare soft tissue thickness (crestal in this case) only used CBCT. Modern algorithms had allowed this stage to be reached.

Cone beam computed tomography systems were originally designed to provide hard tissue visualization of the maxillofacial region.

They excel at this but are now more versatile, with improved capabilities on soft tissue and growing use of AI may see them improve further.

Into The Future

Governments have set up research programs to study the effectiveness of different systems, with larger alternatives to CBCT still in demand but expensive.

The chances are they will opt for increased use of smaller scale devices, especially for maxillofacial units. They are ideal for studying teeth, jaws, TMJ, airways, sinuses and surrounding anatomical structures.

A good consultant will make sure the best type of scan is used, with little vested, practical, or medical rationale not to. There are though sound reasons to use in house CBCT where this suits.

Interactive, 3D images speed up diagnosis, planning and treatment, to the advantage of patients. At times convenient, at others making a difference to how long discomfort lasts and overall outcome.