The benefits of performing dental radiographs (dental x-rays) are well-documented, and full mouth dental radiograph survey is considered the standard of practice in veterinary dentistry. Dental radiography is recognized as a valuable imaging tool with high diagnostic information yield, however, the nature of creating a two-dimensional (2-D) images of a tridimensional (3-D) structures can lead to inherent difficulties in image interpretation or even missing disease that is hidden under superimposed structures.
Technology has advanced to the point where dental practices (human and veterinary) have been able to bring cone beam computed tomography (CBCT) patient side. Cone beam computed tomography is similar to what you may recognize as a CT scan in the hospital but slightly different technology and also on a much smaller scale for the size of the machine and radiation exposure compared to a conventional CT machine.
Cone beam CT allows for very fine detail in multiple views to assess early periodontal disease (around the tooth) and endodontic (inside the tooth) disease that may not be initially visible on standard dental radiographs. It also allows us to look through the entire tooth and around the entire tooth to see bone loss or loss of dental structures that often isn’t visible or is hidden on dental radiographs.
Cone Beam CT also allows for a 3D reconstruction of the skull structures that allows for surgical margin planning for cancer assessment and removal planning, assessing the severity of jaw and skull fractures and finding teeth that are unerupted and the location of these teeth in relation to important blood vessels and nerves so that risk for tissue damage is minimized during the extraction of these unerupted teeth.
Cone Beam CT is also extremely useful for evaluation of the nasal cavities, the sinuses, skull structures, the jaw joints and inside the ears. We often find silent disease in these areas outside of the mouth in our patients either secondary to chronic dental infections or other.
Dental radiographs and Cone Beam CT are complimentary imaging tools and as such, should be used together for a full scope of disease assessment, treatment planning and treatment performed.
The CT scan only takes approximately 20 seconds after the machine is set up around the patient and this allows imaging to be done right at the time of the procedure and does not require a separate appointment.
Here at EVDS, we are extremely fortunate to have this advanced technology available for our patients.