Diagnostic Efficacy of Cone Beam Computed Tomography in Paediatric Dentistry: A Systematic Review and Meta Analysis

Abstract

Background: Regarding the clinical use of CBCT, a sizable number of guidelines have been established, including referral guidelines (sometimes referred to as "appropriateness considerations" and "eligibility requirements"). Although they have been revised, they discovered very little information specifically on the use of CBCT in children.

Aim: This systematic review and meta analysis was carried out to evaluate the diagnostic efficacy of CBCT in children

Methods and Materials: Data were extracted from studies included in systematic review and meta analysis using standardized forms for evaluation of research quality including evidence synthesis. Two review writers independently extracted data for the key studies on diagnostic efficacy, and disagreements were found and discussed with a third independant reviewer wherever required. The following data were included in the information that was extracted: authors details with year and country of publication, clinical context under which the study was carried out, purpose of imaging, level of diagnostic efficacy, description of sample of study participants, study settings, main outcomes of study, strengths of study and weakness of study. The pertinent data was recorded using a specific form for the other study categories. Though they weren't properly reviewed, case reports with less than five distinct cases were compiled to show the usage. Meta analysis was then carried out

Results: 13 publications were included. According to systematic analyses of  research of diagnostic accuracy that were primarily conducted outside human body, CBCT can produce extremely high diagnostic levels of accuracy for root fracture in teeth that have not undergone endodontic treatment. The majority of studies involving the use of CBCT imaging compared to intraoral radiography showed minimal difference in diagnostic accuracy, and the evidence linking to CBCT with caries diagnosis was based primarily on ex vivo research. Acute dental infections were not indicated for CBCT based on any evidence of diagnostic effectiveness, and no pertinent guidelines could be located. According to the data, CBCT scanning is necessary before bone grafting because it enables a volumetric evaluation of the lesion. In perspective of radiation exposure, it is superior to CT.

Conclusion: CBCT can be useful in cases of acute infections of dental origin where traditional radiography technique is not able to indicate about the location of lesion even though there are signs regarding presence of lesion in bone. CBCT is useful in situations when traditional radiographic technique fails to locate suspected fracture of root in teeth having no previous history of endodontic management and subsequently provide adequate assistance in treatment planning.