Jeger Franziska B, Lussi Adrian, Bornstein Michael M, Jacobs Reinhilde, Janner Simone F M
Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern, Bern, Switzerland.
Schweiz Monatsschr Zahnmed. 2013;123(7-8):661-8.
Since the introduction of cone beam computed tomography (CBCT), this 3-dimensional diagnostic imaging technique has been established in a growing number of fields in dental medicine. It has become an important tool for both diagnosis and treatment planning, and is also able to support endodontic treatments. However, the higher effective dose of ionizing radiation compared to conventional 2-dimensional radiographs is not justifiable in every case. CBCT allows for a more precise diagnosis of periapical lesions, root fractures as well as external and internal resorptions. Concerning the utility of CBCT in treatment planning decisions, the gain of information through 3-dimensional imaging for any of these pathologies has to be evaluated carefully on an individual basis. Moreover, radioopaque materials such as root canal filling and posts often create artefacts, which may compromise diagnosis. The aim of this review is to summarize the possibilities and limits of CBCT imaging in endodontology as well as introduce guidelines for daily clinical practice. Furthermore, the article presents possible therapeutic advantages of preexisting CBCT scans for root canal treatments.
自从锥形束计算机断层扫描(CBCT)问世以来,这种三维诊断成像技术已在牙科医学的越来越多领域中得到应用。它已成为诊断和治疗计划的重要工具,还能够支持牙髓治疗。然而,与传统二维X线片相比,其电离辐射的有效剂量更高,并非在每种情况下都合理。CBCT能够更精确地诊断根尖周病变、牙根骨折以及牙体外部和内部吸收。关于CBCT在治疗计划决策中的效用,对于这些病变中的任何一种,通过三维成像获得的信息增益都必须根据个体情况进行仔细评估。此外,根管充填材料和桩等不透射线材料常常会产生伪影,这可能会影响诊断。本综述的目的是总结CBCT成像在牙髓病学中的可能性和局限性,并介绍日常临床实践指南。此外,本文还介绍了现有CBCT扫描用于根管治疗可能具有的治疗优势。