Dental cone beam computed tomography of the jaw vs conventional dental X-ray: why modern dentistry is impossible without tomography?

Dental cone beam computed tomography (CT) is an advanced radiographic diagnostic method that creates a detailed three-dimensional image of the jawbone, teeth, paranasal sinuses, and surrounding structures. It allows dentists and surgeons to accurately assess the condition of teeth, roots, joints, and tissues, identify pathologies and injuries, and plan treatments such as implantation, tooth extraction, or bite correction.

The key and most straightforward difference between tomography and an X-ray image is that an X-ray provides a two-dimensional view of a limited area, while tomography captures a series of images from multiple angles, which can later be digitally reconstructed into a 3D model of the patient's jaw. CT scans offer high-detail visualization of bone structures and tooth roots, making it possible to detect more complex conditions, including microfractures and volumetric formations that may not be visible on a standard X-ray.

This way, the doctor can examine the area of interest from multiple angles, allowing for a more precise and comprehensive treatment plan. It also helps prevent many potential issues early on, even at the stage of cavity treatment.

For example, even during therapeutic treatment, 3D tomography allows for precise determination of the number of root canals (as they can no longer "hide" behind each other) and ensures they are all properly filled. This helps prevent the formation of a cyst in the future. To learn more about the consequences of cyst formation on a tooth root and whether it can resolve on its own, you can read this article.

In what cases is a jaw CT scan essential for dental treatment?

1. Prosthetics

In complex prosthetic cases or when a bite adjustment is required, a CT scan becomes an essential step in diagnostics.

This scan provides the dentist with crucial data on the position of the lower jaw relative to the upper jaw in a closed state, as well as the space between the joint and the joint socket.

Additionally, by using a digital facebow, the dentist can record jaw movement.

This comprehensive approach helps address the following:

• Future tooth modeling – ensuring accurate design
• Identifying contact areas – reducing the need for adjustments and reshaping
• Preventing excessive load on prosthetic teeth
• Minimizing or even eliminating chipping

As a result, tooth modeling is performed more accurately, not just based on aesthetic preferences but on the functional position of the jaw.

2. Implantology

A similar approach is used in implantology. A 3D scanner provides a three-dimensional image of the teeth and gums, while a CT scan generates a detailed 3D image of the teeth and bone structure.

These datasets are then combined in a laboratory to create a surgical guide for implantation, which determines the precise placement of both implants and crowns.

As a result, computed tomography scanning plays a crucial role in reducing risks during implantation by:

• Enhancing accuracy – ensuring optimal implant positioning
• Minimizing invasiveness – leading to smaller wounds and faster healing
• Reducing the risk of affecting anatomical structures – such as arteries and nerves

3. Orthodontics

In orthodontics, CT scanning and digital teeth scanning assist in planning tooth movement.

A jaw computed tomography scan provides the dentist with crucial information on how a tooth can be repositioned, the boundaries of the jawbone, and how the bone may grow or resorb. Additionally, it offers insights into bone density, which helps determine the duration of tooth movement.

4. Endodontics (Root Canal Treatment)

As mentioned earlier, a jaw CT scan allows the dentist to accurately determine the number of root canals and their shape, including any branching. This helps assess the complexity of the treatment and develop the most effective treatment plan.

Which CT Scanner Do We Use in Our Clinic?

At SmileOffice, we use the Carestream 9300 CT scanner with a large 17x11 cm sensor. This advanced equipment allows for the examination of:

• Lateral sinuses
• Temporomandibular joint (TMJ)
• Upper and lower jaws

Additionally, it can scan:

• Eye orbits and frontal sinuses
• Cervical spine

You can book a CT scan or a dental consultation via the link below.