CONE-BEAM COMPUTED TOMOGRAPHY IN DENTISTRY AND MAXILLOFACIAL IMAGING: CLINICAL APPLICATIONS, RADIATION DOSE, OPTIMIZATION AND LIMITATIONS: A LITERATURE REVIEW

Abstract

Background: Cone-beam computed tomography (CBCT) has become an important three-dimensional imaging modality in dentistry, but radiation exposure, dose variability and appropriate indications remain concerns. To review the clinical applications, diagnostic advantages, radiation dose, dose-optimization strategies and limitations of dental CBCT. Methods: A narrative literature review of published studies, guidelines and systematic reviews on dental and maxillofacial CBCT was conducted; dose values were taken from a published meta-analysis and summarized descriptively. Results: CBCT was most useful for implant planning, impacted teeth, endodontic pathology, root resorption, orthodontics, temporomandibular joint assessment and maxillofacial surgery, and its advantage depended on the indication. Reported adult effective doses were 46–1,073 µSv (large field of view), 9–560 µSv (medium) and 5–652 µSv (small), with means of approximately 212, 177 and 84 µSv, respectively. Dose varied substantially between units and protocols. Adjusting tube voltage and tube current–exposure time product reduced dose while maintaining acceptable image quality in selected applications, and diagnostic reference levels (DRLs) varied internationally, with few countries having national values. Conclusion: CBCT offered important advantages in selected conditions but was associated with variable exposure. Justification, field-of-view limitation, parameter optimization and adoption of DRLs are essential.

Keywords: Cone-Beam Computed Tomography; Dentistry; Radiography, Dental; Maxillofacial Imaging; Radiation Dosage; Diagnostic Imaging