Uses of cone-beam computed tomography in San José, Costa Rica

Purpose: To analyze cone-beam computed tomography (CBCT) use, indications, and exposure parameters in San $Jos{\acute{e}}$, Costa Rica. Materials and Methods: A cross-sectional study was performed. All CBCT examinations over a period of 6 months at 2 radiological centers in San $Jos{\acute{e}}$, Costa Rica were evaluated. The examinations were performed with Veraview EPOC X550 and Veraviewepocs 3D R100 equipment. The patients' age and sex, clinical indication for CBCT, region of interest (ROI), repeat examinations, specialty of the referring dentist, field-of-view (FOV), tube voltage (kV), tube current (mA), and radiation dose (${\mu}Gy$) were evaluated. Patients were classified by age as children (${\leq}12years$), adolescents(13-18 years), and adults(${\geq}19years$). Results: The mean age of the 526 patients was 49.4 years. The main indications were implant dentistry and dental trauma. The most frequent ROIs were posterior, while anterior ROIs were much less common. The highest percentage of repeat examinations was in children. Fifty-six percent of the referring dentists were specialists. The most commonly used FOV was small. The mean tube voltage and current were 79.8 kV and 7.4 mA for Veraview EPOC X550 and 89.9 kV and 6 mA for Veraviewepocs 3D R100, respectively. The mean doses for children, adolescents, and adults were $6.9{\mu}Gy$, $8.4{\mu}Gy$, and $7.8{\mu}Gy$, respectively. Conclusion: Although CBCT was most commonly used in adults for implant dentistry, most repeat examinations were in children, and the highest mean dose was in adolescents. Additional dose optimization efforts should be made by introducing low-dose protocols for children and adolescents.