[Radiation exposure and 3 dimensional imaging options of SIREMOBIL Iso-C(3D) for planning surgical dental interventions].
BACKGROUND
Preoperative dental X-ray diagnostics of multimorbid, non compliant patients requiring dental surgery are often insufficient. The SIREMOBIL Iso-C(3D) has made intraoperative 3D imaging available, even for the facial skeleton. This modality was used intraoperatively in two patients referred for surgical dental treatment. Furthermore, radiation exposure of the SIREMOBIL Iso-C(3D), an orthopantomography and a complete dental status was compared.


METHODS
An Alderson-Rando phantom was exposed to ten cycles of the SIREMOBIL Iso-C(3D) using the fast mode (50 projections). In comparison 28 panoramic views of an Orthophos and 10 sets of 14 dental images using the Oralix DC with a quadrate mask were applied. Twenty-five anatomically defined TLD positions were analyzed. Furthermore, SIREMOBIL Iso-C(3D) was used in one patient by performing 100 projections and in a second patient by performing 50 projections. After DICOM-import in eFilm, axial, coronal, and sagittal reconstructions were evaluated by five examiners regarding defined criteria.


RESULTS
The radiation exposure level of the SIREMOBIL Iso-C(3D) was lower than in the complete dental status and only slightly higher in comparison with the orthopantomography, although the system requires the highest number of single projections. Quantitative evaluation of the visualization and recognition of defined structures proved to be very good and good in most points. However, limitations of the system became obvious regarding apical processes.


CONCLUSIONS
Because of the dosimetry results and the visualization of the relevant structures, in patients for whom preoperative images cannot sufficiently be performed, the intraoperative use of the SIREMOBIL Iso-C(3D) as a base examination is justified.
Klinik und Poliklinik für Zahn-, Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg. heiland@uke.uni-hamburg.de
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Heiland
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Schulze
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Flinzberg
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Thurmann
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Rother
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Schmelzle
D000328:Adult; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011862:Radiography, Panoramic / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013515:Surgery, Oral / Q000295:instrumentation; D013819:Thermoluminescent Dosimetry; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D014076:Tooth Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*