Diagnostic efficacy of cone beam computed tomography in paediatric dentistry: a systematic review
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SYSTEMATIC REVIEW
Diagnostic efficacy of cone beam computed tomography in paediatric dentistry: a systematic review K. Horner1,2 · S. Barry1,3 · M. Dave1 · C. Dixon1,3 · A. Littewood4 · C. L. Pang5 · A. Sengupta1,2 · V. Srinivasan3 Received: 12 September 2019 / Accepted: 10 December 2019 © The Author(s) 2019
Abstract Purpose To determine in which clinical situations it is indicated or contra-indicated to prescribe cone beam computed tomography (CBCT) for paediatric patients. Methods Systematic review of in vivo paediatric research studies of diagnostic efficacy using CBCT, with supplementary searches for guideline documents on CBCT and for systematic reviews permitting inclusion of ex vivo and adult studies. Results After screening, 190 publications were included, mostly case studies. No systematic reviews were found of in vivo paediatric research. Fourteen studies of diagnostic efficacy were identified. The supplementary searches found 18 guideline documents relevant to the review and 26 systematic reviews. The diagnostic efficacy evidence on CBCT was diverse and often of limited quality. There was ex vivo evidence for diagnostic accuracy being greater using CBCT than radiographs for root fractures. The multiplanar capabilities of CBCT are advantageous when localising dental structures for surgical planning. Patient movement during scanning is more common in children which could reduce diagnostic efficacy. Conclusions No strong recommendations on CBCT are possible, except that it should not be used as a primary diagnostic tool for caries. Guidelines on use of CBCT in the paediatric age group should be developed cautiously, taking into account the greater radiation risk and the higher economic costs compared with radiography. CBCT should only be used when adequate conventional radiographic examination has not answered the question for which imaging was required. Clinical research in paediatric patients is required at the higher levels of diagnostic efficacy of CBCT. Keywords Cone beam computed tomography · Radiography, dental · Paediatric dentistry · Diagnosis
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40368-019-00504-x) contains supplementary material, which is available to authorized users.
Cone beam computed tomography (CBCT) is used for a wide variety of dental diagnostic uses, including in children and young people (Aps 2013). CBCT typically has a radiation dose one or more orders of magnitude greater
* K. Horner [email protected] 1
Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester M13 9PL, UK
2
Dental Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester M15 6FH, UK
3
Paediatric Dentistry, University Dental Hospital of Manchester, Manchester Univ
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