Digital volume tomography (DVT)

Aside from the extremely limited exposure to radiation that the method imposes on the patient and its phenomenal spatial resolution, its extremely low proneness to artefacts in comparison with dental prosthetics (e.g. implants, crowns, bridgework, inlays and fillings) is another excellent feature of 3D cone beam computed tomography (CBCT) instruments in the Accuitomo class. This was the reason that this diagnostic technique has won out over CT. The artefacts that appear in CT make it unsuitable for use in evaluating implants. In contrast to CT devices, the Accuitomo 170 H170 CBCT device that we currently use allows the examiner to determine the anatomical between the implant and bone, thus allowing him or her to evaluate the success of the implant operation.

Cone beam computed tomography (CBCT), also referred to as dental CT, is a new, ultra-modern x-ray procedure that, while being particularly gentle on the human body, is capable of producing images similar in quality to those of conventional computed tomography (CT).

The CBCT technology that we use (Accuitomo 170 H170 made by Morita in Japan) uses hand-picked components, thus guaranteeing the highest possible image resolution (0.08 mm isotrope Voxel) with the best possible contrast and lowest possible exposure to radiation, a level approximately 90% lower than a conventional CT scan. For that reason, this 3D X-ray technique should be preferred over CT scans in dental and ear, nose and throat diagnostics.  This applies especially in the light of Section 2c of German federal regulations on the use of X-rays (“Anyone who plans carries out or causes to be carried out any activity covered by federal regulations on X-rays, shall be bound to prevent any unnecessary exposure to radiation for human beings and the environment and to restrict exposure to radiation for human beings and the environment to the minimum possible level in the light of the current state of technology and having considered each individual case.”)

A 3D CBCT examination using an Accuitomo 170

is conducted with the patient in a sitting position. The patient sits down on a comfortable armchair. His or her head is maintained in position by means of comfortable padding. We plan out precisely the conduct of our examination in advance with the help of a 3D laser, so that only the relevant area of the body is exposed to radiation. This maximises patient protection from exposure to radiation. An X-ray tube and a solid-state detector then revolve around the patient’s head, generating a three-dimensional, high-resolution, anatomical raw data set whose spatial resolution is several times higher than any conventional CT examination. Images are then constructed out of this raw data set from any spatial perspective required. In cases of dental X-ray examinations, the process can also produce panoramic images or close-up views of individual teeth.

Typical fields of application (indications) for 3D CBCT diagnostics in dental and ear, nose and throat medical X-rays.

  • Dental issues
  • Issues in ear, nose and throat medicine

Dental issues

  • Implantological diagnostics and planning: e.g. evaluation of available bone, examination using surgical drill template, imaging using 3D record for planning implants
  • Ailments of the periodontal apparatus (e.g. cysts, granulomas, inflammations and fractures of dental roots, periodontal disease)
  • Diagnosis and location of dental apparatus, tooth retention and mislocated teeth
  • Diagnosis of the physical relationship of teeth with one another
  • Detection of position of wisdom teeth in relation to nerves of the lower jaw
  • Diagnosis of fractures in the upper or lower jaw (traumatology)
  • Diagnosis of congenital deformities: e.g. cleft lip and palate
  • Diagnosis of ailments of the jaw joints: e.g. arthrosis
  • Planning and monitoring of orthodontic therapies

Issues in ear, nose and throat medicine

  • Diagnosis on inflammation of the sinuses (sinusitis)
  • Assessment of curvature in the septum (nasal septum deviation)
  • Assessment of nasal septum perforation
  • Diagnostics on the base of the skull
  • Diagnosis of injury (fractures) of the facial area and the base of the skull
  • Assessment of the upper airways in patients who snore (due to obstructive sleep apnea) and in patients with nasal polyps
  • Diagnostics in the jaw joints of patients with earache (otalgia)
  • Diagnostics in the middle and inner ear, e.g. inflammations (inflammations of the middle ear – otitis media, mastoiditis, labyrinthitis ossificans, cholesteatoma), fractures, dislocation of the bones of the inner ear, otosclerosis or congenital deformities (dysplastia).