The current status of cone beam computed tomography imaging in orthodontics

Abstract

Cone beam CT (CBCT) has become an increasingly important source of three dimensional (3D) volumetric data in clinical orthodontics since its introduction into dentistry in 1998. The purpose of this manuscript is to highlight the current understanding of, and evidence for, the clinical use of CBCT in orthodontics, and to review the findings to answer clinically relevant questions. Currently available information from studies using CBCT can be organized into five broad categories: 1, the assessment of CBCT technology; 2, its use in craniofacial morphometric analyses; 3, incidental and missed findings; 4, analysis of treatment outcomes; and 5, efficacy of CBCT in diagnosis and treatment planning. The findings in these topical areas are summarized, followed by current indications and protocols for the use of CBCT in specific cases. Despite the increasing popularity of CBCT in orthodontics, and its advantages over routine radiography in specific cases, the effects of information derived from these images in altering diagnosis and treatment decisions has not been demonstrated in several types of cases. It has therefore been recommended that CBCT be used in select cases in which conventional radiography cannot supply satisfactory diagnostic information; these include cleft palate patients, assessment of unerupted tooth position, supernumerary teeth, identification of root resorption and for planning orthognathic surgery. The need to image other types of cases should be made on a case-by-case basis following an assessment of benefits vs risks of scanning in these situations.

Three-dimensional morphological condylar and mandibular changes in a patient with juvenile idiopathic arthritis: interdisciplinary treatment

“…In addition to clinical and laboratory findings, CBCT is useful in diagnosing and treating early JIA. Patients with CBCTpositive TMJ damage cannot be identified by means of a simple clinical examination, whereas CBCT can quantify morphological changes of the condyle and mandible (15). In comparison with CBCT, magnetic resonance imaging (MRI) takes longer and can be difficult in the case of patients who are unable to sit (or be held) still for a long period of time, which means that children (particularly young children) may require general anesthesia or conscious sedation.…”

Accuracy of Orthodontic 3D Printed Retainers versus Thermoformed Retainers

“…The 3D technology [1] [2] [3] as one of the most inspiring current digital technologies, has enhanced our capabilities, allowed better visualization and more effective communication with the patients. As far as the orthodontic discipline, this 3D technology has paved the way for virtually designing and fabricating orthodontic appliances.…”

Reliability of three-dimensional anterior cranial base superimposition methods for assessment of overall hard tissue changes: A systematic review

“…1,4 However, two-dimensional (2D) cephalometric radiographs suffer from a number of inherent flaws, such as errors generated because of inadequate patient head position, alignment of the imaging device, inherent geometric distortions, and differential magnification created by projection distance and beam divergence. 1,[5][6][7][8][9] During the past decade, craniofacial three-dimensional (3D) digital records have become increasingly popular among orthodontists as the specialty progressed toward a 3D virtual representation of the patient for diagnosis, treatment planning, and surgical simulation. The advanced imaging capabilities of conebeam computed tomography (CBCT) are depicted through 3D cephalometric analysis, temporomandibular joint visualization, and 3D evaluation of dental anomalies, to name only a few.…”

“…4,10 A single scan provides an overlap-free 3D visualization of different components of the skull, enables volumetric measurements to be made, and allows a detailed assessment of the maxillofacial structures in variable thickness of the axial, coronal, and sagittal slices, providing real measurements with no magnification. 9,11 Recently, similar to 2D cephalometric tracings, CBCT images can be superimposed, allowing a 3D evaluation of growth changes, treatment effects, and stability over a certain time interval through registration points, angles, shapes, and volumes. [12][13][14] One of the main challenges of 3D superimposition of serial images is to understand that linear/angular measurements in 2D and 3D images are not directly comparable because of differences in size, shape, and relative spatial location of the skeletal, dental, and soft tissue between the two imaging systems.…”