Cone beam computed tomography (CBCT) has infiltrated every dental specialty over the past few years, including orthodontics. In addition to aiding in the assessment of skeletal and dental structures, localizing and evaluating impacted teeth and supernumeraries and TMJ assessment, CBCT also plays a vital role in airway analysis, the planning of temporary anchorage devices, the fabrication of custom orthodontic appliance and digital model creation and storage. Other benefits include improved diagnoses, faster examinations and enhanced patient communication and case acceptance.
Diagnosis and Treatment
TMJ Assessment—CBCT systems with multiple fields of view give doctors the flexibility to assess temporomandibular joint changes, as well as the surrounding structures. Not only are CBCT scans more accurate than 2D imaging, but one 360 degree scan can capture both the right and left TMJ, thus simplifying patient positioning.
Airway Analysis—As airway analysis becomes more widespread in orthodontics, dedicated 3D imaging software will allow doctors to visualize constrictions by segmenting the airway in a few clicks. These visually appealing 3D images can also help doctors communicate with patients.
Temporary Anchorage Devices (TADs)—CBCT gives doctors a highly detailed overview of bone quality and quantity, the location of the sinuses and root proximity, all vital to know before considering placing TADs. Three-dimensional imaging software can also simulate implant placement for increased confidence and a more accurate treatment planning.
Custom Appliances—Studies show that the use of 3D imaging greatly increases accuracy in creating custom orthodontic appliances. The combination of CBCT, additional technology and the right software creates a highly accurate digital set-up that can be used by labs to create custom appliances for a better fit and faster turnaround.
Digital Model Creation, Storage and Analysis—Advanced multi-functional CBCT systems are able to scan existing stone models and traditional impressions in order to digitize them. Scanning stone models aids in storage, as the model can then be safely destroyed, while scanning impressions allows doctors to quickly send files to a lab for appliance fabrication. In both cases, digital models can be analyzed in 3D and used for case presentation
When using a system’s low-dose mode, CBCT can deliver less radiation than panoramic imaging. Also, selectable fields of view allow doctors to limit the range of radiation. Both of these elements aid orthodontists in controlling dose exposure for their young patients, who are more susceptible to radiation.
Case Presentation and Acceptance
When orthodontists can present a case to a patient and their parents in 3D, it greatly aids in case acceptance. Not only is the patient able to understand the diagnosis and visualize the treatment better, but the “cool factor” of 3D technology impresses young patients and reassures parents of the doctors’ advanced technology and expertise.
Panoramic imaging and cephalometric imaging remain a key part of orthodontic diagnosis and treatment, however, there’s no denying the benefits that adding CBCT to an orthodontic practice can bring. As refinements to the technology and enhancements to imaging software continues, there are bound to be even more opportunities for and benefits to using CBCT in orthodontics.