History and Importance in Dentistry - Dr Yoshinori Arai and Dr Piero Mozzo independently developed Cone Beam Computed Technology for oral and maxillofacial radiology. - The first commercial system, the NewTom 9000, was introduced in the European market in 1996 and the US market in 2001. - CBCT is considered the gold standard for imaging the oral and maxillofacial area. - CBCT can show critical root canal anatomical features that conventional intraoral or panoramic images cannot. - 3D images produced by CBCT enhance diagnosis and influence treatment in endodontics. - CBCT is used for presurgical assessment of dental implant sites. - CBCT provides an undistorted view of the dentition, allowing accurate visualization of erupted and non-erupted teeth, tooth root orientation, and anomalous structures.

Applications in Interventional Radiology - CBCT became practical for clinical use in interventional radiology procedures with the adoption of flat-panel X-ray detectors. - Many C-arm fluoroscopy systems are capable of CBCT acquisitions. - CBCT aids image guidance during interventional radiology procedures for various medical conditions. - CBCT is used in the treatment of knee osteoarthritis, benign prostatic hyperplasia, and hepatocellular carcinoma. - CBCT potentially reduces patient radiation exposure when used before fluoroscopy.

Industrial Applications - CBCT is used for material analysis, metrology, and nondestructive testing in the manufacturing sector. - CBCT can inspect and detect defects of tiny sizes, such as internal pitting corrosion or cracks, in quality control. - Cone beam reconstruction algorithms, such as filtered backprojection or iterative reconstruction, are used in CBCT for material analysis. - CBCT is used to improve quality control and ensure the integrity of manufactured objects. - CBCT is effective in detecting and analyzing defects in industrial applications.

Risks and Disadvantages - CBCT involves ionizing radiation, which carries potential risks. - Total radiation doses from CBCT exams are lower than conventional CT exams but higher than standard dental 2D x-ray. - The recommended standard of care is to use the smallest possible field of view, voxel size, mA setting, and exposure time. - International organizations and legislation emphasize the importance of weighing risks and benefits before performing CBCT procedures. - CBCT technology may be susceptible to movement artifacts and lacks appropriate bone density determination. - The Hounsfield scale, used to measure radiodensity, may be inaccurate in CBCT scans due to varying greyscale values. - CBCT HU values are unreliable for determining site-specific bone density for dental implant placement. - CBCT systems do not employ a standardised system for scaling grey levels, making assessment of bone quality difficult.

Integration and Advancements - Image quality and time are significant factors affecting the integration of CBCT in interventional radiology. - Wider collimation in CBCT leads to increased scatter radiation and decreased image quality. - The temporal resolution of CBCT detectors slows data acquisition time and increases motion artifacts. - CBCT image reconstruction takes longer compared to MDCT due to computationally demanding algorithms. - Ongoing advancements in CBCT technology aim to improve image quality and reduce acquisition and reconstruction time.