Use of CBCT in dental implantology: a cross-sectional survey among postgraduate students in Italy

Abstract Aims and objectives Cone-beam computed tomography (CBCT) is now widely used in dental practice as a 3D imaging modality, largely because it offers lower costs and reduced radiation exposure compared with conventional CT. However, this feature of accurate imaging with a lower radiation dose than CT led many clinicians to perform CBCT scans more frequently, even when there was no indication. The aim of this study was to investigate how postgraduate students in oral surgery and implantology use radiological imaging, including CBCT, during their diagnostic and operative workflows. Materials and methods An online questionnaire was used to survey postgraduate students enrolled in the oral surgery and implantology programs at two Italian universities (Chieti and Bari) during the winter semester of 2024. Participation was entirely voluntary, with no rewards or penalties for participation. The questionnaire comprised various question formats, including yes/no, multiple choice, and close-ended questions. The questions were designed to cover various aspects of knowledge related to using CBCT in dental implants, along with the latest recommendations based on current evidence. Out of 650 invitations sent, 282 doctors fully completed the questionnaire, while the remaining 38 responses were excluded due to incomplete answers. We analyzed the associations between pairs of categorical variables using Pearson’s chi-square test of independence, in order to assess the statistical significance of the comparisons. Results A highly significant association emerged between attendance at implantology training courses and the prescription of CBCT exams ( p = 0.00066). Furthermore, professionals who report knowing the guidelines for prescribing radiological exams are statistically more likely to specify the field of view field of view and technical parameters (mA, kVp) when requesting the exam ( p = 6.0452e-61). The use of virtual planning software for guided surgery is also significantly associated with participation in specific training courses ( p = 0.0006623). Conclusions Our findings revealed that, despite a high level of awareness of the presence of CBCT, practitioners often lacked an understanding of the negative consequences, indications, features, and radiation doses of CBCT that are associated with increased stochastic effects. This is mainly due to the misconception that CBCT is a low-dose test, which led many implantologists to prescribe needless CBCT and, even more concerning, follow-up radiographs.