CBCT imaging in children with special healthcare needs

Dental Tribune International

Wed. 3 December 2025

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MALMÖ, Sweden: New research conducted at Malmö University has found that radiation exposure from dental imaging can be reduced for paediatric patients with special healthcare needs, including those with cleft lip and palate, while maintaining adequate imaging quality. It also developed a new artificial intelligence (AI) tool to improve preoperative planning and thus support more precise, efficient care.

The Faculty of Odontology at Malmö University, a leading centre for dental education and research, presented the new findings on how to optimise radiographic protocols for children and adolescents with special healthcare needs. The work, a doctoral thesis by researcher Dr António Vicente, focused on dose optimisation for patients born prematurely and on those with orofacial clefts, two groups that often require repeated imaging.

Dr Vicente developed and tested a low-dose CBCT protocol for postoperative assessment of children with orofacial clefts and compared it with a standard protocol. “The higher the radiation dose, the better the image quality. But it turned out that the images with a lower radiation dose were of sufficiently high quality to be able to conduct these postoperative assessments,” he concluded. Although observers reported somewhat lower confidence in their evaluations when using the low-dose images compared with images obtained with the standard-dose protocol, Dr Vicente’s protocol was judged clinically adequate for follow-up.

To streamline planning for alveolar bone grafting, Dr Vicente also developed an AI tool for automated segmentation of the cleft area on CBCT scans. Trained on CBCT scans of unilateral clefts, the AI system was able to delineate the cleft region and estimate bone graft volume with high accuracy, potentially reducing workload and improving consistency in preoperative planning. “This helps to ensure that operations can be performed with greater precision and, in the long run, means better care for these patients,” Dr Vicente said.

Another component of the thesis addressed concerns that preterm children may receive higher cumulative radiation doses because of extensive medical imaging early in life. Reviewing dental records from 311 preterm and full-term children and adolescents, Dr Vicente found no significant differences in the number of dental radiographic examinations between the groups. Although dental behaviour management problems during examinations and treatment were more common in the preterm group, this did not translate into poorer dental status or more referrals to paediatric dental specialists.

The thesis, titled Radiographic Examinations in Dental Care for Paediatric Patients With Special Healthcare Needs, was published by Malmö University Press and defended at the faculty on 24 October 2025.

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