Digital volume tomography of the facial skeleton

Christoph M. Ziegler; Thomas Klimowicz; Nils Petter Fossland

doi:10.4045/tidsskr.11.0802

Commentary

Digital volume tomography of the facial skeleton

Norwegian

Christoph M. Ziegler, Thomas Klimowicz, Nils Petter Fossland

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Christoph M. Ziegler

Christoph Mike Ziegler (born 1964) Dr. med., Dr.med. dent., Dr. med. habil., Professor at the Norwegian University of Science and Technology and Privatdozent at the University of Heidelberg. He is head of the Department of Oral and Maxillofacial Surgery, St. Olav’s Hospital and Chairman of the Norwegian Association of Maxillofacial Surgery. He holds several specialist authorisations (as an oral surgeon and maxillofacial surgeon, among others), has a large number of international publications and lectures to his name and previously also headed the Division of Maxillofacial Radiology at the University of Heidelberg.

Conflicts of interest: None declared.

Email: ziegler@ntnu.no

Department of Neuroscience

The Norwegian University of Science and Technology

and

Department of Oral and Maxillofacial Surgery

St Olav’s Hospital

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Thomas Klimowicz

Thomas Richard Klimowicz (born 1974) Specialist in oral surgery with special expertise in oral medicine. Dr. med. dent. degree from the University of Erlangen-Nürnberg. He is Senior Dental Consultant at the Department of Oral and Maxillofacial Surgery, St. Olav’s Hospital. He has conducted research and published articles on digital volume tomography.

Conflicts of interest: None declared.

Department of Oral and Maxillofacial Surgery

St Olav’s Hospital

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Nils Petter Fossland

Nils Petter Fossland (born 1974) Doctor in specialist training in the fields of ear, nose and throat and maxillofacial surgery. He is currently employed at the Department of Oral and Maxillofacial Surgery, St. Olav’s Hospital.

Conflicts of interest: None declared.

Department of Oral and Maxillofacial Surgery

St Olav’s Hospital

Article

Digital volume tomography is a radiological technique for three-dimensional imaging of anatomical structures and pathological changes in the maxillofacial area. We believe it has many advantages over conventional computed tomography.

High resolution computed tomography of the type cone beam computed tomography (CBCT) is a technique based on X-ray transmission projection of specific two-dimensional absorption images. The technique is also called digital volume tomography (DVT) and was originally developed for diagnostics in dental and maxillofacial radiology. The method can be used to produce an accurate 3D image of osseous structures of the face without metal artefacts. Because of the compact size of the equipment, simple technical handling and the rapid examination it offers, digital volume tomography is a good diagnostics tool in facial traumatology and in the ear, nose and throat field. The question of whether the CT method entails a higher or lower radiation dose than conventional CT is a matter of controversy. Roberts et al. measured a radiation dose for full-dose scanning of the head as being 92.8 µSv to 206.2 µSv, and hence less than that used in corresponding conventional CT scanning (1).

Fig. 1 shows a DVT image of a patient with bullet wounds after the implantation of a large amount of osteosynthetic material. This method resulted in an image without artefacts, whereas traditional CT was of limited use because of metal artefacts and unsatisfactory 3D modelling (Fig. 2).

Figure 1 CBCT 3D midface reconstruction — **Figure 1** CBCT 3D midface reconstruction

Figure 2 CT 3D midface reconstruction — **Figure 2** CT 3D midface reconstruction

Figs 3 and 4 show CBCT images of anatomical structures in the nose, maxilla, larynx and throat. The two-dimensional image shows retention polyps in the left maxillary sinus (fig. 3), but no pathological airway changes were found in the larynx or throat (fig. 4).