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Beam Volumetric Imaging (CBVI)
have both!
Not every patient requires a cone beam panoramic is the most appropriate diagnos- assessment, then you would order additio-
scan. Stand-alone cone beam devices tic radiographic evaluation in many cases, nal imaging to the panoramic such as CBVI
require you to expose the patient to the whereas the reconstructed panoramic image (Images 2a and 2b) to determine the posi-
entire cone beam X-ray dose and then play is often much “less diagnostic”. tion of the inferior alveolar nerves. Both
with the software to extract or reconstruct examinations take into consideration the
a panoramic image. This is both time- For example, if you are trying to patient’s needs, reducing the X-ray dose to
consuming and inappropriate, since you det ermine if the adult teeth are present and As Low As Reasonably Achievable – that
had to subject the patient to a larger X-ray in the correct eruption orientation or posi- is, you’ve used the ALARA principle. The
dose than if you had been able to perform tion for a 9-year-old, a simple panoramic radiographic procedure should always
the panoramic alone. In addition, the diag- image is sufficient (Image 1). If however, the match the diagnostic task.
nostic information from a high resolution next patient is a 17-year-old whose pano-
ramic image is for third molar extraction
