Effect of Milliamperage Reduction on Pre-surgical Implant Planning Using Cone Beam Computed Tomography by Surgeons of Varying Experience

BACKGROUND

Differences in CBCT units and the lack of standardization result in exposure to radiation doses beyond what is required for diagnostic purposes, especially when planning the surgical placement of dental implants.

AIM

To assess the influence of low- and high-dose milliamperage settings on CBCT images for objective and subjective implant planning among senior specialists (5 years of experience) and juniors (fresh graduates).

MATERIALS AND METHODS

Two dry skulls (4 hemi-maxillary segments of the maxilla and 4 hemi-maxillary segments of the mandible) were scanned under low (2 mA) and high (6.3 mA) dosage settings using the Carestream CS 9300 machine. Cross-sectional slices of both image qualities were evaluated by the 5 seniors and the 5 juniors for subjective image utility for implant planning and for objective linear bone measurements.

RESULTS

There were no significant differences in bone measurements taken on high- or low-dose images by all seniors and by the majority of juniors (p > 0.05). In qualitative image assessments, there was independence between assessment and image quality for almost all observers. For planning posterior mandibular implant placement, increased dosage improved concordance and kappa values between low- and high-dose images for senior observers (from K = 0.287 at low dose to K = 0.718 at high does) but not for juniors (K = 0.661 and K = 0.509 for low and high dose, respectively).

CONCLUSION

Reduction in milliamperage did not affect diagnostic image quality for objective bone measurements and produced sufficient concordance for qualitative assessment. Judicious optimization of milliamperage settings based on individual diagnostic requirements can result in significant dose reduction without compromising diagnostic decision-making.

Non Hodgkin's lymphoma of the maxilla as a first clinical manifestation of HIV infection. Report of a case

Non-Hodgkin's lymphoma (NHL) of the oral cavity is rare. When it occurs, one should be suspicious of infection with the human immunodeficiency virus (HIV). NHL is the second most common malignancy associated with the acquired immunodeficiency syndrome (AIDS). This report describes the occurrence of a maxillary NHL as a primary clinical manifestation of HIV infection.

Duplicated mandibular canal: report of a case

Standard anatomy textbooks describe the mandibular canal as having a consistent, standard path. The fact that variations in its path exist in a significant percentage of the population is of extreme importance for the surgeon who is performing procedures in close proximity to the mandibular canal. A rare, radiographically detectable variation of the standard anatomy of the mandibular canal is reported.