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American Academy of Periodontology publishes proceedings on cone-beam computed tomography

October 11, 2017

By David Burger

When to use and when not to use cone-beam computed tomography for certain periodontal related procedures and implants is the topic of proceedings published by the American Academy of Periodontology in October.


Dr. Kornman
The "best evidence consensus" proceedings are the result of the American Academy of Periodontology's meeting in Chicago in February. The meeting featured discussion about the best available published research and expert opinion on CBCT best practices when there is insufficient evidence to arrive at definitive conclusions.

The proceedings appear in the October issue of the Journal of Periodontology and online at joponline.org.

"As new technologies emerge, it often takes many years for sufficient high-quality evidence to allow clinicians to appropriately incorporate the technology into patient care," said Dr. Kenneth Kornman, Ph.D., the editor of the Journal of Periodontology in an ADA News interview. "The best-evidence-consensus reports are designed to bridge the gaps and provide evidence summaries and expert interpretations that guide clinical use now, if appropriate in specific clinical scenarios."

CBCT, introduced just over two decades ago, is a medical imaging technique consisting of X-ray computed tomography where the X-rays are divergent, forming a cone. The three-dimensional nature of CBCT may provide enhanced diagnostic information and increased accuracy compared to 2-D imaging.

The proceedings address questions regarding when the enhanced insight generated from CBCT imaging warrants its use — in regards to radiation damage, which is cumulative — and include a statement from an expert panel of clinicians and scientists with extensive experience in the use of CBCT in the following specific clinical scenarios:
  • The surgical management of patients requiring dental implants.
  • Determining risk to periodontal structures in patients requiring periodontal-orthodontic treatment.
  • Diagnostic assessment and treatment planning in managing patients with periodontitis.

The panel determined that CBCT has diverse applications for both dental implant and periodontal-orthodontic therapies and should be used when the benefit to the patient outweighs the risks. While the panel said that 2D full-mouth radiographs combined with clinical probing remains the "gold standard" when it comes to treating patients with periodontitis, CBCT may be beneficial in certain advanced and complex cases.

"CBCT in the hands of clinicians experienced in the use of the technology can serve as a useful tool that may improve patient care," said Dr. Steven Daniel, president of the American Academy of Periodontology, in a news release. "Its utility in some of the complex cases that  periodontists routinely manage today may guide the use of specialized surgical approaches that allow for more predictable outcomes."

Enhancing clinical outcomes for patients with complex treatment needs remains the utmost concern, Dr. Kornman said. "We anticipate that the reports will help us apply new technologies in appropriate, well-defined clinical scenarios to help improve the health of our patients," he said.

For more information about the American Academy of Periodontology or periodontal disease, visit perio.org.