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Current Status and Issues with Dental and Maxillofacial CBCT: Potential Methodologies for Quality Control and Management of This Technology

D Mihailidis1*, E Gingold2*, R Pizzutiello3*, (1) University of Pennsylvania, Philadelphia, PA, (2) Thomas Jefferson University, Philadelphia, PA, (3) Victor, NY


(Wednesday, 7/15/2020) 3:30 PM - 4:30 PM [Eastern Time (GMT-4)]

Room: Track 4

We will be addressing the potential issues with managing dental and maxillofacial CBCT scanners and the need to develop testing methodologies and approaches that will be applicable to the variety of the available units. Unfortunately, there isn’t a one-size-fits-all approach that can easily be established however, there may be potential to develop a comprehensive approach, like setting a testing baseline for image quality evaluations, dose measuring and reporting, that can be employed for continuous quality management. The information that will be presented in this session may be useful to any practicing medical physicist, especially to a consulting physicist who is called to test a dental or maxillofacial CBCT in a private office, most times with limited resources.

Several approaches are available to quantify patient radiation dose from dental/maxillofacial CBCT. Although classified as CT scanners by regulators, traditional CT dose metrics cannot be measured in the field because of the non-traditional scanner geometry. We will present suitable alternatives for quantifying radiation dose including Dose (Kerma) Area Product and entrance skin exposure (air kerma), as well as incident air kerma at the image receptor for quality control purposes.

Individual State regulations for CBCT vary widely, with some treating CBCT as a conventional dental intraoral unit and others having specific requirements. The Conference of Radiation Control Program Directors (CRCPD) has published a 2017 Technical White Paper on CBCT for Dental Applications. An overview of State requirements and the CRCPD recommendations will be reviewed. Academic dental programs and oral and maxillofacial surgery centers are increasingly becoming accredited. Accreditation is not mandated for most dental installations because they do not bill for Medicare. Updated 2018 IAC Dental CT Accreditation Standards and Guidelines will be reviewed.

Learning Objectives:
1. Give an update of the current status of dental and maxillofacial CBCT technology systems.
2. How dental and maxillofacial CBCT technology does presents a testing challenge for the practicing medical physicist. Why “one-size-fits-all” approach is not easily applicable.
3. Present potential methodologies and testing approaches for performing quality control evaluation for dental and maxillofacial CBCT. What current guidelines recommend and what accreditation requirements include.



Cone-beam CT, Dental Radiography, Quality Control


IM- Cone Beam CT: Dental

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