Annonce

Cone Beam CT-undersøgelse af børnepatienter

ABSTRACT

Oversigtsartikel Dato: 26.11.2015

Cone Beam computer-tomografi (CBCT) er en avanceret 3-d-røntgenmetode, der, alt efter størrelsen af billedfeltet og spatialopløsningen, er forbundet med højere stråledosis end konventionelle 2-d-røntgenmetoder. Derfor har Statens Institut for Strålebeskyttelse (SIS) skærpet kravene for tandlæger, der ønsker at arbejde med CBCT i daglig praksis. De skal gennemføre et tredelt kursusforløb, der bl.a. består af tre dage med teoretisk efteruddannelse omhandlende dels tekniske aspekter og dels indikationerne for, hvornår man bør anvende CBCT. Der er stadig sparsom evidens for, hvornår CBCT er indikeret, men det forventes, at CBCT vil gavne patienter med: ektopisk lejrede maksillære hjørnetænder, odontomer og andre retinerede tænder, nogle tilfælde med retinerede mandibulære 3. molarer, interne og eksterne tandresorptioner samt eruptionsforstyrrelser. Derudover kan CBCT anvendes forud for ortodontisk behandling i komplicerede tilfælde og som led i behandling af traumepatienter. Det kræver god instruktion af barnet forud for undersøgelsen for at opnå optimale billeder uden bevægelsesartefakter og dermed undgå omtagninger og yderligere stråling. Formålet med denne oversigt er at gennemgå indikationerne for CBCT-undersøgelse af børn.

Cone-beam CT examination of children Cone-beam computed tomography (CBCT) is an advanced 3D imaging method. Depending on the size of field-of-view and spatial resolution, CBCT delivers higher radiation doses than conventional 2D imaging methods. Consequently, the Danish Health and Medicine Authorities have strengthened the rules for dentists, who want to work with CBCT in their practice. The dentists need to fulfil a postgraduate course where one part out of three is a theoretical training in technical aspects, diagnostics and indications for the use of CBCT. There is still sparse evidence on when a CBCT examination is indicated, but it is expected that patients may benefit from a CBCT examination when the following situation has been diagnosed in a 2D image: ectopic maxillary canines and other impacted teeth; odontogenic tumours such as odontomas; cases of impacted mandibular third molars where CBCT images may change the treatment plan, internaland external pathological resorptions, and further in cases with disturbances in the eruption pattern of the permanent dentition. Moreover, CBCT may be used prior to orthodontic treatment in complicated cases with skeletal deviations and during treatment of patients who have suffered from trauma to the dentition. To avoid retakes and additional radiation, children need a careful instruction prior to a CBCT examination to achieve optimal images without motion artefacts. The aim of this review is to suggest indications and guidelines for a CBCT examination of children as described by Department of Dentistry, Oral Radiology, Aarhus University and to provide examples of clinical situations, where CBCT was indicated.

Kommentarer
Annonce