cone beam international magazine of cone beam dentistry

I 09 case report _ CBCT in maxillofacial surgery I cone beam2_2014 CBCT is superior to CT and MRI in the assessment of boneinvasionbytumoursinthemaxillofacialregion. FurtheradvantagesofCBCTimagingincludelowerra- diationdosesthanMSCTanditsabilityconcerningthe anatomicassessmentofthestomatognathicsystem. _Case report This case report concerns a 55-year-old male patient suffering from oral squamous cell carci- noma (Fig. 1). The CT scan did not show any clear bone invasion in this case (Fig. 2). In order to obtain information that was more precise and to deter- mine appropriate surgical planning related to the extentofboneinvasion,aCBCTscanofthemandible was performed (SCANORA 3Dx, SOREDEX, Tuusula, Finland). In the axial view (Fig. 3), it may be seen that the tumour had invaded the lingual mandibu- lar cortex in the symphyseal region, extending up to the buccal cortex. OnDemand3D image editing software (Cybermed) offersatoolforthequantificationofmeasurements by using the ROI and Profile function. ROI analysis of the bilateral segments of the mandible showed a lower average grey scale value in the suspected osteolytic zone (Figs. 4 & 5). After a detailed examination of the suspected mandibular bone invasion, a precise surgical plan couldbecompiled.Resectionlinesweredetermined according to the profile and ROI tool results (Fig. 6). In this case, a marginal mandibular resection was the treatment of choice, performed “en bloc”with a specimentakenbyradicalneckdissection(Figs.7&8). _Conclusion According to the adequate CBCT-based pre- operative surgical planning, the tumour could be resected in toto, showing free margins in the non- resected area of the mandible. Owingtoitsvariabilityinimagingandresolution, CBCT could be of great importance in oncological surgery and diagnosis._ Acknowledgement: The authors acknowledge support from the Ministry of Science of the Republic of Serbia (project#17507). Editorial note: A complete list of references is available fromthepublisher. Fig. 5_Lower grey scale values, a distance of approximately 16.64 mm. Fig. 6_Pre-op planning for the mandibular resection. Fig. 7_Marginal resection. Fig. 8_Surgical specimen en bloc after radical neck dissection. Dr Drago B.Jelovac,DMD,MSc,MSIII,is a PhD studentandresidentmaxillofacialsurgeonattheClinic for Maxillofacial Surgery of the Faculty of Dental Medicine at the University of Belgrade in Serbia. Prof.Vitomir S.Konstantinović is a member of the teaching staff at the Clinic for Maxillofacial Surgery of the Faculty of Dental Medicine at the University of Belgrade. cone beam_authors Fig. 6Fig. 5 Fig. 8Fig. 7