Clinical Application of Cone Beam Digital Volume Tomography in Children with Cleft Lip and Palate

Objectives: The diagnostic advantages of digital volume tomography (DVT) over conventional imaging and computed tomography are demonstrated in terms of the respective radiation exposure. The potential role for three-dimensional imaging in cleft lip and palate patients is illustrated on the basis of clinical examples.

Methods: The radiation exposure resulting from scans using a cone beam DVT (NEW TOM QR-DVT 9000, Marburg, Germany) was measured with an Alderson-Rando-Phantom (The Phantom Laboratory, New York, NY) and compared with that resulting from other standard imaging modalities. The patient sample consisted of young children with cleft lip and palate on whom orthodontic and surgical treatment was planned on an interdisciplinary basis at the University-Hospital of Heidelberg.

Results: Digital volume tomography allows high-quality three-dimensional imaging of the premaxilla region, with an effective equivalent investigation dose of (110 kV, 5.4 mA) 0.342 mSv based on ICRP recommendations. While the effective equivalent investigation dose for DVT is higher than that for standard imaging techniques (for example digital panoramic radiograph Orthophos Plus DS Ceph (66 kV, 8 mA) 0.016 mSv), it is much lower than that for a normal CT scan (e.g. Picker International Inc., Highland Heights, OH) adjusted at (spiral 130 kV, 125 mA, and 30 mA, 1.5 s) 2.27 mSv. Digital volume tomography provides extensive data important in clinical decision making.

Conclusions: The clinical examples show the good applicability of DVT with a reduced radiation dose.