X-ray indications

The need for recordings is always assessed by dentists at the clinic in terms of indication for X-ray examination as well as the recommended type of admission.

Panoramic recording indications:

- Overview recording of teeth and jaws in addition to clinical examination in connection with treatment planning.
- Pre-examination in connection with implant treatment (extension and course of anatomical structures, in particular sinus maxillaris and canalis mandibulae).
- Assessment of retined wisdom teeth (positioning, relation to canalis mandibulae and any pathological conditions such as resorptions and cyst development).
- Major pathological changes such as cysts and tumors that cannot be uncovered in their entirety by intraoral recordings.
- Verification of developmental analmalia (e.g. ectopically camped teeth).
- Assessment of dental systems and supplement to clinical examination in connection with orthodontic treatment planning.
- Changes located outside the areas that can be uncovered using intraoral film.
- Alternative to intraoral recordings in patients who cannot open their mouth sufficiently for the placement of intraoral image receptor or by pronounced pharynx reflex.
- Indicative recording by fracture diagnosis (of jaws and facial differences).
- Overview image from which areas can be selected for more sub-detail study.

Indications for Cone Beam CT study:

- Preoperative examination for implant treatment.
CBCT can show the height and width of the proc. alveolaris. The need for CBCT is assessed on the basis of panoramic or single-tooth recordings as well as clinical findings. There is an indication for the use of CBCT if there is uncertainty about the height and width of the alveoli as well as relation to e.g. sinus maxillaris, canalis mandibulae, foramen mental or canalis incisivus maxillae.

- Retinated teeth
(a) Canines of the upper jaw.
X-rays with intraoral images are indicated by:
1) Asymmetry by palpation of upper jaw canines or pronounced difference in eruption on the right and left sides.
2) Not palpable canines at normal break-up time.
3) Late eruption or dislocation of the lateral incisives.

If the canines cannot be free-projected from the lateral incisives on intraoral images, CBCT may be indicated, especially in case of suspected root reorption.

b) The wisdom teeth of the lower jaw.
In complicated root anatomy, uncertainty about the localization of canalis mandibulae and verification of suspected resorption damage to neighboring tooth.

c) Other retinated teeth with unclear location and anatomy and possible damage to neighbouring structures.

- Teeth in patients with unclear pain problems to exclude periapical pathologies and where intraoral images or panoramic smoke have shown normal conditions.

- Suspected internal/external resorption.
Where resorption is suspected but where intraoral images cannot be determined whether it is internal or external; or if the extent of a resorption is to be clarified.

- Jaw joints
1) In clinically diagnosed arthrose, where the treatment has not had an effect and where it is likely that CBCT may change the choice of treatment.
2) In the case of systemic joint disease.
3) Suspected ankylosis, tumours or congenital malformations.
4) In trauma where fracture is suspected.

- Large room-filling processes (cysts, tumours and the like) for the purpose of examining the size and relation to the surrounding structures where it affects treatment.

- Root/tooth and jaw trauma (except for suspected root fracture in tooth with metal pin build-up and possible root filling material).

Information about radiation doses

Below is the estimated effective radiation dose indicated. In comparison, the average dose from background radiation in Denmark is 8 μSv/day.

Intraoral recording (1 image): 1-5 μSv. Panoramic recording: 6-29 μSv (Carestream CS8100).

Cone Beam CT*: 5-72 μSv** (Carestream CS8100).
*The dose depends on the size of the radiation field/volume and the level of resolution. The minimum volume size in relation to the indication shall be used.

**See "Radiation Dosage Chart for CS8100 3D Family"