Three-dimensional Extraoral Digital Imaging

The advances in Cone Beam Computed Tomography (CBCT) allowing three-dimensional digital imaging in the last decade is impressive. General and specialty dental practices certainly benefit from a 3D digital system that includes panoramic, cephalometric, and Cone Beam imaging programs (Figures 29-30).

Figure 29. 3D Digital Imaging Software.
Photograph showing 3D Digital Imaging Software.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.
Figure 30. 3D Digital Imaging System.
Photograph showing 3D Digital Imaging System.
Image Source: Schick by Sirona, Sirona Dental, Inc., Long Island City, NY.

The digital panoramic images are clear and detailed. With the new technology, dental providers can take partial panoramic views of a certain area, instead of a full panoramic image. Imaging system options include TMJ and sinus views, endodontics, dental and bone fractures, impacted teeth, abnormal anatomy, measuring bone dimensions for dental implants, and cleft palate assessment. Orthodontic and pediatric dental practices can benefit from digital cephalometric imaging, allowing full width lateral, posterior anterior, and reduced width lateral views. The detail from digital imaging also allows for cephalometric hard and soft tissue tracing. Dental practices that perform endodontic treatment can also benefit from 3D digital imaging including pre-, working, and post-imaging diagnoses. As we know, endodontic radiographs can be challenging.4 As with intraoral digital imaging, extraoral digital imaging requires less radiation to the patient, compared with medical computed tomography (CT). Scanning time is approximately 8-10 seconds. This is also helpful for cancer patients who have been exposed to medical therapy radiation (Figures 31-33).

Figure 31. 3D Imaging for Diagnoses.
Photograph showing 3D Imaging for Diagnoses.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.
Figure 32. 3D Imaging for Diagnoses.
Photograph showing 3D Imaging for Diagnoses.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.
Figure 33. 3D Dental Implant Treatment Planning.
Photograph showing 3D Dental Implant Treatment Planning.
Image Source: Sordex, Kavo Kerr Group Powai, Mumbai.

With 3D digital imaging, the results are detailed and can be enhanced with digital imaging software for region-of-interest (ROI) magnification and equalization. Dental practices that place dental implants will also have access to an extensive implant library from manufacturers. Some disadvantages with CBCT include the cost of the equipment, lack of training in interpreting structures outside what dental providers were taught with two-dimensional digital imaging, and mistakes with dental providers not including a field of view (FOV) wide enough to diagnose diseases and conditions.2,5,9