# Ten Years of Micro-CT in Density and Maxillofacial Surgery: A Literature Overview
## 5 Conclusions  
Micro-CT is an established technique that has demonstrated various advantages for many applications. In the last ten years, the improvement in image analysis allowed to highlight some opportunities offered by microtomographic technology, which until a decade ago, were considered only as potential benefits. This overview aimed to collect and discuss the main topics investigated in studies carried out using laboratory micro-CT in dentistry and MFS, published in the last ten years and its potential in developing new studies, answering the main proposed research questions. The discussed studies were rigorously collected by searching the main literature databases. After a full-text review, 105 articles were investigated from an initial total amount of 160 records obtained from the databases search. The graphic of Figure 3 allows visualizing the distribution in percentage of the total number of articles in relation to the topics and types of studies discussed in this work. Starting from the literature evidence acquired by the reviews recorded (19% of total records), the greater amount of studies, about 70%, are focused on dentistry applications. MFS studies are limited, about 13% and some are associated with the analysis of treatments also applicable in dentistry  
Figure 3: Distribution of the studies discussed in the text according to the topics indicated as the categories (**1**–**8**) on the horizontal axis; the number of records discussed in the text is indicated as an absolute value on the vertical axis and as a percentage value of the total studies considered in the graphical representation. (about 3%). Micro-CT enables the scanning of objects with small dimensions and this aspect may have limited the adoption of the methodology, which is not suitable for some maxillofacial anatomical districts with respect to other tomography systems. From the point of view of the study typology, the percentages are similar for in vitro and in/ex vivo studies. It should be noted that some studies, about 12%, use both approaches for defining a complete assessment. The main detected records confirmed that an established range of micro-CT applications are related to studies performed to investigate new biomaterials and their effects on osseointegration, bone structure, bone grafts, and tissue response in dentistry. Furthermore, mineral tissues analyses, as well as evidence of specific treatments in orthodontia, represent the micro-CT core business. Most of the applications are effectuated in research settings and for scientific purposes. Some limitations observed and that limited the spreading in clinical settings, were related to the operating costs and data processing time. Safety, cost-effectiveness, and efficiency still relieved to be some of the required challenges. Despite that, health care systems and private clinicians could benefit from it for various applications, traditional and emerging, as the assessment of patient-matched devices realized in point of care and based on 3D reconstructed models, eventually also for regulatory purposes. This overview dedicated a section to the challenges of microtomographic evaluations combined with other technologies and techniques, highlighting the growing possibilities and the potential extension of the field of applications. Almost 49% of the discussed studies were carried out considering a multimethod approach using micro-CT with other techniques (Figure 3). Traditional methodologies as microscopy, histology, and mechanical characterization are confirmed conventionally associated with micro-CT. Numerical-based methods are the main emerging ones with a high potential growing and impact. The integrated approach is interesting and promising for the future developments. The adoption of micro-CT in the daily clinical routine continues to represent the true goal. The definition of procedures or guidelines could allow a better comparison of the results for its use also integrated with other technologies and in relation to specific treatments.