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ePaper created 2014-12-05, 15:38:45 | version 1.33.01
I 09 opinion _ CBCT in dental office I cone beam4_2014 CBCT “selectively, as an adjunct to conventional radiography.” The ADA further recognises the value and presence of CBCT by including CBCT-related courses at its annual meetings and continuing education courses during the year. The American Association of Oral and Maxillo- facial Surgery (AAOMS) has over 9,000 members representing approximately 95 % of oral and max- illofacial surgeons practising in the US. Literature addressing the application of CBCT in oral and maxillofacial surgery has been around since 2007. The AAOMS has offered continuing education in the use and application of CBCT for patient care as far back as 2011.The AAOMS has worked with the IAC to develop guidelines and accreditation criteria for 3-D CBCT imaging. In a recent survey of OMFS residency programmes, 87 % of programme direc- tors acknowledged the use of CBCT in patient care by their residents. The American Association of Endodontists (AAE) and the American Association of Oral and Maxillo- facial Radiologists (AAOMR) have released a formal position paper on CBCT. This paper makes many important points, such as limiting the field of vision to minimise radiation exposure and increase reso- lution, careful patient selection in CBCT, and the responsibility of the clinician to interpret the entire image. The position paper goes on to declare “the use of CBCT in endodontics should be limited to the assessment and treatment of complex conditions.” The article then lists nine of these “complex condi- tions”. In summation, the position paper recognises the value of CBCT as an adjunct to 2-D images and “CBCT may provide dose savings over multiple traditional images in complex cases”. Literature pertaining to the use of CBCT in endo- donticsfirstappearedintheJournalofEndodontics in 2003. The American Association of Endodontists sponsor continuing education in endodontic re- lated CBCT on their website and the organisation devotesvaluabletimeatitsannualmeetingtoCBCT as it relates to modern endodontics. Most resi- dencies (44 of 47) in endodontics provide CBCT for patient care. Literature pertaining to CBCT in dentistry dates back to 1998. The AAMOR devotes considerable efforttocontinuingeducationrelatingtoCBCTboth on its website, through CE events, and at its annual meeting. All seven ADA approved residencies in RadiologyincorporateCBCTeducationandtraining into the resident curriculum. The tremendous value of anatomic truth in complex orthodontic cases involving patients with cleft lip and palate, impacted teeth, and maxillofa- cial deformities is widely recognised and discussed in the literature. Review of the AAO annual meeting lecturesyllabusshowsCBCTisaprominenttopicfor today’sorthodontist.InarecentarticleintheJournal of Dental Education by Smith et al use of CBCT in orthodonticprogrammesintheUSandCanadawas evaluated. This article showed the following: _83 % of orthodontic programmes have access to CBCT, _73 % of programmes report “regular” use of CBCT in patient diagnosis, _Areas of CBCT use focuses on diagnosis and treat- ment planning for: impacted teeth, craniofacial anomalies,TADplacement,TMJassessment,upper airway analysis, and maxillofacial development. Literature discussing CBCT in periodontics first appeared in the AAP journal over a decade ago. The American Association of Periodontist annual meeting agenda and the JournalofPeriodontology demonstrate a heavy influence of CBCT in the field ofperiodontics.All51post-doctoralUSperiodontal programmes use CBCT in patient care. The International Congress of Oral Implanto - logists (ICOI), the world’s largest dental implant organisation and provider of dental implant con- tinuing education with an excess of 25,000 active members, published a consensus report on CBCT in its journal ImplantDentistry in April of 2012. In the article, authored by many leaders in the dental im- plant field, the ICOI states: “The literature supports the use of CBCT in dental implant treatment plan- ningparticularlyinregardstolinearmeasurements, 3-D evaluation of alveolar ridge topography, prox- imity to vital anatomic structures, and fabrication of surgical guides.” The ICOI reminds the dentist that use of CBCT must be justified in each case and should be considered as an imaging alternative where conventional radiographs may not provide sufficient anatomic truth. Literature discussing the application of CBCT in implant dentistry is ubiqui- tous and comprises the lion’s share of research in applying CBCT technology to dentistry. The vast majority of post-doctoral residencies involved in dental implant patient care and all private dental implanttrainingcoursesintheUSincorporateCBCT in their dental implant education curriculum. Many professional organisations in dentistry for general dentists and specialists have weighed in onCBCTbyprovidingrecommendations,guidelines, and a position paper. While these guidelines are beneficial in establishing a society or specialty’s position on CBCT, they are not mandates. Recom- mendations, guidelines, CE programmes, and posi- CBE0414_06-11_Whitesides 28.11.14 11:55 Seite 4 CBE0414_06-11_Whitesides 28.11.1411:55 Seite 4