Evaluation of Cone Beam Computed Tomography (CBCT) Utilization for Pre-Surgical Assessment in Oral and Maxillofacial Units in South West Nigeria

Cone beam computed tomography (CBCT) provides high-resolution three-dimensional imaging of hard and soft tissue structures, offering significant diagnostic advantages over conventional two-dimensional radiography in oral surgical planning. Despite its growing adoption globally, CBCT utilization for pre-surgical oral and maxillofacial assessment in Nigeria remains inconsistent and understudied. This mixed-methods study evaluates the availability, utilization patterns, and clinical impact of CBCT on pre-surgical assessment decisions in oral and maxillofacial surgery units across five teaching hospitals in the South West geopolitical zone. A structured questionnaire was administered to 48 oral surgeons, supplemented by analysis of 150 clinical cases involving CBCT assessment during the study period. Outcome data include type of procedure planned, diagnostic information gained from CBCT not available on panoramic radiographs, and changes in surgical planning attributable to CBCT findings. Results show that CBCT altered the surgical plan in 37% of cases, most commonly for impacted tooth proximity to the inferior alveolar nerve, jaw pathology extent, and implant site assessment. However, CBCT was available at only three of the five institutions, and cost was identified as a prohibitive factor for routine use. The study recommends investment in CBCT infrastructure, development of radiation justification guidelines for CBCT in Nigerian oral surgery contexts, and training of oral surgeons in CBCT image interpretation. Keywords: CBCT, pre-surgical assessment, oral surgery, South West Nigeria, imaging.