Maxillofacial Radiology

• What is Maxillofacial Radiology?
• Techniques Employed to Acquire an Accurate Diagnosis
• What about Radiation Exposure in the Dental Office?
• What Are the Indications for Cone Beam Scanning (iCAT CT Scans)?

What Is Maxillofacial Radiology?

The use of radiology and good imaging techniques are of the utmost importance when compiling a complete database from which to make a diagnosis and plan surgery. To that end, the office x-ray unit has long been a staple of the physician and dentist’s armamentarium. In fact, there is hardly a patient of this current generation that can remember a time prior to when their general dentist could snap a picture and show them on a viewer which of their teeth were decayed and those that needed repair. As with all technological wonders, these techniques and imaging systems have only continued to improve with time. In the case of radiology, the biggest improvements have occurred in the areas of increased portability, a decreased invasiveness and the rendering of more precise information.

Techniques Employed to Acquire an Accurate Diagnosis?

One of the radiological techniques with which many patients are already familiar is the “panorex” plain film taken to evaluate the jaws for issues related to pathology of bone, wisdom teeth and trauma. Combined with smaller dental x-rays (periapicals), these films provide a valuable two dimensional or linear study that is typically sufficient for the diagnosis and treatment planning of most patients’ problems. However, when a more detailed examination of anatomy is required, a three dimensional study is sometimes called for. This study is called a computed tomogram, or “cat scan.” A tomogram is a film that is taken with the film and x-ray beam rotating around the patient. A “computed” tomogram involves the adjunctive use of a computer to gather the data from the scan and apply a mathematical algorithm to produce a three dimensional image.

What about Radiation Exposure in the Dental Office?

All living things are exposed to “background” radiation from the environment. Older dental x-ray machines and hospital CT scanners (cat scans) exposed the patient to high doses of radiation. Advancements in the technologies used by “modern” equipment to take small dental x-rays and the panorex radiograph has rendered these devices absolutely safe and has reduced the amount of radiation exposure in the dental office to a point that is nearly insignificant. However, even more exciting are the advances made of late in three dimensional scanning as an outpatient in the oral surgeon’s office. This newer three dimensional scanning technique using a form of “cone beam” radiation exposes the patient to only 10% of the background radiation they would normally be exposed to in a single year of background radiation.

The application of this safe technology now allows for a thorough evaluation of the maxillofacial region in the comfort of an outpatient office setting. When deemed necessary, a cone beam CT scan can provide the three dimensional information required for an accurate diagnosis and treatment plan with the lowest possible exposure to radiation.

What Are the Indications for Cone Beam Scanning (iCAT CT Scans)?

A patient may need a CT scan to study dental, skeletal and/or soft tissues of the head and neck. Some dental applications include the evaluation of dental implant sites and the precise position of impacted teeth. Skeletal images are used to study cysts, tumors and other diseases that affect the jaws, measure the jaws for planning orthognathic reconstructive surgery, identify the cause of temporomandibular disorders and look at the spine to evaluate a patient’s skeletal maturity. Lastly, the scan can provide critical information for patients with breathing difficulty related to obstructive sleep apnea (OSA).

At this time, “cone beam” CT scans can only be obtained at a limited number of locations in the Connecticut area. Most surgeons are still required to send their patients to the hospital for conventional CT scans that are significantly more expensive and that cause considerably higher exposures of radiation. We are pleased to say that the “Simsbury Office” of Connecticut Maxillofacial Surgeons now offers cone beam CT technology without a trip to the hospital and the added radiation dose of a conventional CT scan. Our staff can quickly perform the scan and the surgeon can discuss preliminary findings during the same consultation appointment. When necessary, your CTMAX doctor will also acquire a second opinion from a radiology specialist in “oral and maxillofacial radiology” by simply downloading your scan for his review. This service is both convenient and more affordable than conventional CT scans. While we regularly use this technology to assist in the diagnosis and treatment planning of our own patients, we are now able to offer this service to any patient that is referred by a qualified professional.

For any additional questions regarding the use of imaging to acquire a diagnosis and to treatment plan your maxillofacial problem, please do not hesitate to contact one of our offices or ask your doctor during your consultation visit.

The information listed above is the opinion of the doctors of Connecticut Maxillofacial Surgeons, L.L.C. and does not necessarily reflect the opinion of the specialty as a whole.