CBCT의 선택과 처방
How to Choose and Use the CBCT
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1990년대 후반 소개된 Cone Beam ComputedTomography(CBCT)는 구강악안면방사선학 영역에서 획기적인 변화를 가져왔다1, 2). 기존의 일반 방사선촬영술에서는 불가능했던 치아와 악골의 3차원적인 진단이 가능하게 되었고, 일반 medical CT보다 낮은 방사선 노출량으로 영상을 획득할 수 있고, 개인용 컴퓨터와 소프트웨어로 쉽게 영상을 분석할 수 있고, 장비의 설치에 필요한 공간이 줄었으며, 비교적 저렴한 가격으로 장비를 구매할 수 있게 되었다. CBCT의 적용가능한 임상 분야 또한 악안면 경조직 병소의 진단과외과적 처치에 대한 접근, 임플란트 치료계획 및 술후평가3~5), 측두하악관절 병소의 진단 및 평가6~8), 치아및 안면골 외상의 진단1, 9, 10), 근관치료를 위한 치아와치근단 질환의 평가11), 교정치료와 악교정 수술을 위한술전 진단 및 술후 평가1, 12~14) 등으로 매우 다양하다. 특히, 임플란트 치료에 대한 관심과 대중화는 치조골의계측 및 3차원적 분석, 골질의 객관적 평가, 주요 해부학적 구조와의 관계 등을 비교적 쉽게 평가할 수 있는CBCT의 도입과 급속한 파급을 가능하게 하였다.
Abstract
The emergence of Cone Beam Computed Tomography(CBCT) in the late 1990s represented an innovative advancement in the field of dental and maxillofacial radiology because it greatly reduced the radiation exposure to patients and offered 3D images easily. The 3D information generated by this technique brings the potential of improved diagnosis and treatment planning for a wide range of clinical applications in dentistry. The use of CBCT includes diagnosis and surgical assessment of the orofacial hard tissue lesions, dental implant treatment planning and postoperative evaluation, TMJ assessment, diagnosis of craniofacial fracture, orthodontics, endodontics, and so on. All CBCT examinations should be justified on an individualized needs. The clinical benefits to the patient for each CBCT scan must outweigh the potential risks associated with exposure to ionizing radiation. CBCT scans should be taken with initially obtained medical and dental histories of patients and a close clinical examination. CBCT should be considered as an imaging alternative of other conventional radiography in cases where the anatomical structures of interest may not be seen. The smallest possible field of view(FOV) and the lowest setting of tube current and scan time should be chosen, and the entire images scanned should be interpreted by a qualified expert.
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