Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Knowledge, Attitude and Awareness of CBCT and

CT Among Dental Students in Chennai –
A Questionnaire Study
Dr.K.Pazhanivel1, Dr.Priya Ramani2 , T.MathiBharathi3, M.S.Mathivadhani4, Meenakshi Arumugam5
1
Senior Lecturer, Department of Oral Medicine & Radiology,
Thaimoogambigai Dental College and Hospital, Chennai, India.
2
Head and Professor, Department of Oral Medicine & Radiology,
Thaimoogambigai Dental College and Hospital, Chennai, India.
3
Junior Resident, Department of Oral Medicine & Radiology,
Thaimoogambigai Dental College and Hospital, Chennai, India.
4
Junior Resident, Department of Oral Medicine & Radiology,
Thaimoogambigai Dental College and Hospital, Chennai, India.
5
Junior Resident, Department of Oral Medicine & Radiology,
Thaimoogambigai Dental College and Hospital, Chennai, India.

Abstract:- dimensional imaging technologies for better and accurate

Aim and Objectives: To assess the Knowledge, Attitude diagnosis.
and Awareness of CBCT and CT among dental students
across Chennai, Tamilnadu. Materials and Methods: A Keywords:- Awareness, CBCT, CT, Dental Radiology,
structured, self-administered online-based cross- Diagnosis, Digital Imaging, Field of View, Radiation
sectional questionnaire study consisting of 15 relevant exposure.
questions were used to assess among 155 dental students
across Chennai, Tamilnadu through Google forms I. INTRODUCTION
distributed on various social media platforms. The
obtained data was analyzed using SPSS version 24.0, and In dentistry, radiographic evaluation is critical for
any P ≤ 0.05 was considered as statistically significant. diagnosis and treatment planning. The inherent drawbacks of
Results: Of all 155 dental students enrolled in the study, two-dimensional imaging is not limited to compressing the
majority of the dental students (86.4%) were familiar three-dimensional (3D) anatomical structures of the
with the term CBCT among which 40% and 35.5% radiographed region into a two-dimensional one (2D) but also
gained more Information about CBCT through lectures includes compromised magnification, image distortion, and
and seminars/CDE/Workshops respectively. 20% of the superimposition, all of which contribute to structural
dental students were unaware of the radiation dose misrepresentation [1, 2]. In such situations, Cone Bean
differences while a very low response rate was obtained Computed Technology (CBCT) or computed tomography
about knowledge on pixels (34.8%), picture element (CT) scanners may be utilized to aid diagnosis, evaluation of
(29%) and different sizes of field of view (FOV) used in disease severity, therapy planning and administration, and
CBCT imaging (45.2%). Though more than half of the appropriate follow-up [3].
dental students (51%) recommend CBCT for various
dental application, 63.2% agree inadequate teaching at Computed Tomography (CT), a high-quality 3D
the undergraduate level on 3D imaging techniques imaging technology that has become widely prevalent in
(CBCT/CT), 78.7% had shown interest to attend courses dental practice since its development in 1972 and is now
pertaining to CBCT in the near future. Conclusion: The recommended before various procedures for visualization of
present study clearly shows lack of knowledge among dental hard tissues as well as osseous structures in the oral
dental students despite adequate awareness and positive cavity including dental pathologies [4, 5]. Though intraoral
attitude on various application aspects of CBCT/CT. This radiographs remains gold standard radiographic diagnostic
observation undoubtedly necessitates the need for tool that aid in detection of dental pathologies, these images
inclusion of new technologies in the oral radiology does not provide complete and superior in-depth details as
curriculum, organizing CDE programs, training courses compared with CBCT/CT that delivers three-dimensional
and workshops to increase the knowledge awareness and diagnosis and treatment planning information with a wide
guide the future dental practitioners to apply three- range of clinical applications. Furthermore, with high quality
images and less radiation doses, introduction of CBCT in

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Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
dental and maxillofacial imaging specifically designed to the dental students (51%) reported low radiation dose of
capture the volumetric characteristics of the craniofacial CBCT than CT as the most common reason for its preference
region gives an excellent opportunities to dental surgeons to however 20% were unaware of the radiation dose differences
work accurately in a wider applications ranging from between them while a very low response rate was obtained
assessment of impacted third molar in proximity to vital about knowledge on matrix individual blocks in CT as 34.8%
structures, analysis of jaws for implant placement, evaluation considered it as Pixel and 29% selected as picture element.
of dento-facial region for and /or during orthodontic
treatment, Temporo-mandibular joint disorders, On assessment on attitude and practice awareness
dentoalveolar trauma, pulp and periapical pathologies towards CBCT against CT in dentistry, majority of the dental
including cysts, tumors, and abscess, detection and students prefer CBCT for 3D imaging of head and neck
characterization of the bony aspects of periodontal disease, region (67.1%), for locating the impacted maxillary canine
and endodontic applications [6, 7, 8, 9]. (60%), while 40.7% recommend CBCT for detecting the
morphology of root canal, and 27.1% for detection of number
The usage of CT in dental practice was largely affected of canals in endodontic practice (Figure 3). One third of the
by its high cost, increased radiation exposure and limited dental students (34.2%) reported pleomorphic adenoma cases
accessibility whereas CBCT imaging is less expensive, and 27.1% responded internal disc arrangement cases are
require minimal space than CT scanners, produces rapid high absolute contraindication of CBCT in diagnostic imaging
quality images at short scanning time with beam limited to among which 36.1% considered in CT, patient will be in
head and neck region, reduced magnitude of irradiated areas, supine position; while in CBCT, and patient will be either
decreased radiation doses and also possess multivariate standing or sitting position as the major technical difference
display modes to enhance ideal imaging despite poor soft exception between the two imaging procedures (Figure 4).
tissue contrast, beam hardening artefacts and scatter artefacts
from previous restorations and metallic crowns [10, 11]. Majority of the dental students (63.2%) agree
Thus, clinicians and dental surgeons should use CBCT only inadequate teaching at the undergraduate level on 3D imaging
when there is need and it cannot be taken adequately by lower techniques (CBCT/CT) and lack of participation (72.9%
dose conventional dental radiography or alternate imaging never attended) in any CBCT related courses in the past or
modalities [12, 13]. during the course of their dental education training as reasons
for lack of sufficient knowledge (Figure 5) . It was also
II. MATERIALS AND METHODS illustrated that more than half of the dental students (51.6%)
recommended CBCT should be a part of dental curriculum
A questionnaire-based cross-sectional assessment and education in final year and 30.3% recommended CBCT
survey was carried out amongst the dental students (Final as a part of third year (BDS) dental curriculum to gain
years, Interns, PGs) across Chennai, Tamilnadu to assess their adequate theoretical knowledge (Figure 6). Lack of
Knowledge, Attitude and Awareness of CBCT and CT. After awareness (34.8%) and lack of availability (34.2%) as a key
obtaining the Ethical clearance, the prerequisite information factor for not using CBCT in their dental practice, among
was collected and 15 relevant questions were prepared using which 78.7% are willing to practice and had shown interest
available evidence-based literature about the present study. to attend courses pertaining to CBCT in the near future
The self-administered questionnaire was distributed among (Figure 7).
undergraduate and postgraduate dental students with few
selected responses to specific questions along with close-
ended questions. Since this study was carried out during the SOURCE OF KNOWLEDGE ABOUT
COVID-19 Pandemic situation, online Google forms were CBCT
generated and circulated through various social media
platforms.

III. RESULTS 7% Seminars/

workshops/
On analysis of the given data, it was observed that the 17% 36% CDE
majority of the dental students were Final year undergraduate
dental students (58.7%) followed by CRRIs/Internship Lectures by
faculty
students (32.2%) and the least being postgraduate dental
students (9.1%) respectively. Of all the 155 dental students
enrolled in the present study, majority of the dental students 40%
(86.4%) were familiar with the term CBCT that stands for
Cone Beam Computed tomography . On further evaluation of
knowledge awareness towards CBCT/CT it was observed
40% and 35.5% gained more knowledge/Information about Fig 1 Pie diagram showing the source of knowledge about
CBCT through lectures and by attending CBCT
seminars/CDE/Workshops respectively (Figure 1) among
which 67.1% prefer CBCT and only 17.4% opted CT for 3D
imaging of head and neck region (Figure 2). About half of

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Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165

3D Imaging of Head and Neck Reason for not using CBCT in routine
practice
3%

12% 18%
CT 12% lack of awareness

CBCT 35% lack of knowledge

MRI
lack of availability
34%
ULTRASOUND
tough to perform
67% 19%

Fig 2 pie diagram showing the recommended 3D imaging Fig 5 pie diagram showing the reason for not using CBCT in
techniques for head and neck routine dental practice

CBCT IN DENTAL EDUCATION

CBCT in Endodontics

6%
12% 1st year
19% detection of
27% canals 2nd year

detection of 52% 3rd year

13%
morphology of
30% 4th year
canals
tooth vitality
41% detection

Fig 6 pie diagram showing the dental education in CBCT

Fig 3 pie diagram showing the application of CBCT in acquired in
endodontics
120.00%
DIFFERENCE BETWEEN CBCT and CT 100.00%
21.30%
Except 80.00% 36.80% 45.20%
60.00% 72.90%
fan shape cone beam
shaped 40.00% 78.70%
63.20% 54.80%
21% supine and sitting 20.00% NO
22% 27.10%
position 0.00%
YES
FOV

21% Detector area and line

36%

Fig 4 pie diagram showing the difference between CBCT Fig 7 bar graph showing the yes or no responses
and CT except

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Volume 7, Issue 12, December – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IV. DISCUSSION relationship of image with the exposure factors [9]. A very
low response rate was obtained about knowledge on matrix
Cone beam computed tomography (CBCT) has largely individual blocks in CT as 34.8% considered it as Pixel and
replaced CT and emerged as a key tool in 3- dimensional (3D) 29% selected as picture element. Similar low responses
modality of choice in dental imaging and diagnosis. Though (45.2%) were also reported on knowledge towards different
it has developed as an innovation in dental imaging, sizes of field of view (FOV) used to take CBCT scan which
guidelines based on studies with low levels of evidence was inconsistent with study by Nagarale R et al [6], Al-
demanded additional research on CBCT effectiveness and its Noamam RF et al [10].
clinical implications as majority of previous studies focused
largely on digital methods and radiation protection protocols. Balabaskaran et al [11], Sathawane R et al [12] in their
Very few studies evaluated knowledge, attitude and respective studies showed majority of the dental students
awareness among dental students towards their clinical refer CBCT for various dental applications similar to our
application had shown clear lack of knowledge, awareness study where 67.1% opted 3D imaging of head and neck
and hesitancy towards its use and diagnostic importance in region, for locating the impacted maxillary canine (60%),
routine dental practice [1-5]. This necessitated the inclusion while 40.7% recommend CBCT for detecting the
of new technologies in the oral radiology curriculum to guide morphology of root canal, and 27.1% for detection of number
the future dental practitioners and apply three-dimensional of canals in endodontic practice. Studies by Kamburoglu K et
imaging technologies for diagnosis and treatment planning. al [2], Gunasekaran S et al [3] and Shetty SR et al [13] were
The present study used modified questionnaire to assess the in agreement with our study results where dental students
knowledge and awareness on various application aspects of agree lack of awareness (34.8%) and lack of availability
CBCT and CT and also to establish the importance of dental (34.2%) as a key factor for not using CBCT in their dental
students' attitudes towards new technologies among practice. It was evident that 78.7% are willing to practice and
undergraduate and post-graduates across Chennai, had shown interest to attend courses pertaining to CBCT in
Tamilnadu. the near future comparatively lower than observations by
Gunasekaran S et al [3] and Shetty R et al [13].
In the present study majority of the dental students
(86.4%) were familiar with the term CBCT among which V. CONCLUSION
40% and 35.5% gained more knowledge/Information about
CBCT through lectures and by attending The present study clearly shows lack of knowledge
seminars/CDE/Workshops (75.5%) respectively which was among dental students despite adequate awareness on various
consistent with the studies conducted by Mahabob MN et al application aspects of CBCT in comparable to CT. More than
[1], Kamburoglu K et al [2] and Gunasekaran S et al [3] half of the dental students had shown interest to attend
among which 67.1% prefer CBCT and only 17.4% opted CT courses pertaining to CBCT signifies positive attitude
for 3D imaging of head and neck region which was relatively towards implementing CBCT in routine dental practice. This
higher than other studies carried out by Gunasekaran S et al necessitated the inclusion of new technologies in the oral
[3], Lavanya R et al [4] and Almohiy H et al [5]. More than radiology curriculum, organizing continuing dental education
half of the dental students (51.6%) recommended CBCT programs, training courses and workshops to increase their
should be a part of dental curriculum and education in final knowledge awareness and guide the future dental
year and 30.3% recommended CBCT as a part of third year practitioners to apply three-dimensional imaging
(BDS) dental curriculum to gain adequate theoretical technologies for better and accurate diagnosis and
knowledge which was similar to the results by Kamburoglu management.
K et al [2], Gunasekaran S et al [3], and Lavanya R et al [4].
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