Cone Beam Computed Tomography

The cone beam computed tomography is a three-dimensional skull radiograph and has less exposure to radiation than the older computed tomogram (CT). While traditional X-ray images are always projections of the subject on a single plane, the CBCT allows three-dimensional view, revealing the real extent and positional relationship of structures. Indications for a CBT are the planning of dental implants, in orthodontics e.g. the assessment of heavily impacted tooth buds.

Great skepticism is appropriate when applying the recently fashionable three-dimensional skull radiographs with the cone beam tomography (CBCT). The data obtained with a CBCT has little or no contribution to the planning of routine treatments for patients so this elaborate technique has little benefit.

A CBT causes a manifold radiation load emitted on the body contrary to a standard panoramic X-ray. Therefore, for legal reasons, the administration of multiple CBCT’s without due cause is regarded as criminal assault. Unfortunately, habit is hard to break and routine CBCTs have been administered during recent years from the United States to Germany. Again, collecting diagnostic data is only useful if it has beneficial results for the therapy.

This also applies to orthodontics: the collection of diagnostic data makes sense only if it results in consequences for the therapy, and modern technology is not only per se a good thing, if there are better alternatives. We refer about 1-2% of our patients to specialists who make a CBCT. For this reason, we do not operate our own CBCT in our practices.

In our practice in Mannheim, Dr. Madsen is certified specifically for the evaluation of CBCT data concerning the few cases in which this aspect is of real importance.