The diagnostic efficacy of cone beam CT for impacted teeth and associated features: a systematic review.

This review evaluates the evidence for the diagnostic efficacy of cone beam computed tomography (CBCT) for impacted teeth and associated features. PubMed, Embase and the Cochrane Library were searched using specific indexing terms and reference lists were hand searched. Two reviewers selected relevant publications on the basis of pre-determined inclusion criteria. Original studies were assessed using a modification of the quality assessment of diagnostic accuracy studies (QUADAS) tool. The literature search yielded 96 titles, of which 7 were included in the review. There was only limited evidence for diagnostic efficacy expressed as sensitivity, specificity and predictive values. Only two studies compared CBCT and panoramic radiographs with a valid reference method and presented the results in terms of percentage of correct diagnoses. This review reveals a need for studies that meet methodological standards for diagnostic efficacy of CBCT in the diagnosis of impacted teeth.

Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot study.

AIM: To evaluate the precision of transfer of a computer-based three-dimensional (3D) planning, using re-formatted cone-beam images, for oral implant placement in partially edentulous jaws. MATERIAL AND METHODS: Four formalin-fixed cadaver jaws were imaged in a 3D Accuitomo FPD cone-beam computed tomography (CT). Data were used to produce an accurate implant planning with a transfer to surgery by means of stereolithographic drill guides. Pre-operative cone-beam CT images were subsequently matched with post-operative ones to calculate the deviation between planned and installed implants. RESULTS: Placed implants (length: 10-15 mm) showed an average angular deviation of 2 degrees (SD: 0.8, range: 0.7-4.0 degrees ) as compared with the planning, while the mean linear deviation was 1.1 mm (SD: 0.7 mm, range 0.3-2.3 mm) at the hex and 2.0 mm (SD: 0.7 mm, range 0.7-2.4 mm) at the tip. CONCLUSIONS: Cone-beam images could be used for implant planning, taking into account a maximal 4 degrees angular and 2.4 mm linear deviation at the apical tip.