scholarly journals Cone-Beam Computed Tomography in Orthodontics

2019 ◽  
Vol 7 (3) ◽  
pp. 89 ◽  
Author(s):  
Ahmad Abdelkarim

Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.

2012 ◽  
Vol 23 (5) ◽  
pp. 602-607 ◽  
Author(s):  
Karla de Faria Vasconcelos ◽  
Yuri Nejaim ◽  
Francisco Haiter Neto ◽  
Frab Norberto Bóscolo

A radiographic interpretation is essential to the diagnosis of invasive cervical resorption (ICR) and the difficulty in distinguishing this lesion from internal root resorption has been highlighted in the literature. This paper reports the use of cone beam computed tomography (CBCT) in the diagnosis of ICR. The cases reports describe how CBCT can be used to make a differential diagnosis and also show that the use of this technology can provide relevant information on the location and nature of root resorption, which conventional radiographs cannot. As a result, the root canal treatment was not initially considered. The patients will be monitored and will undergo a scan after a short period of time to detect any small changes. It was observed that both cases benefited from CBCT in the diagnosis of ICR, because this imaging modality determined the real extent of resorption and possible points of communication with the periodontal space.


2020 ◽  
Vol 63 (4) ◽  
pp. 188-193
Author(s):  
Girish Katti ◽  
Syed Shahbaz ◽  
Chandrika Katti ◽  
Mohd Sabyasachi Rahman

Background: Cone beam computed tomography (CBCT) imaging techniques are the recent rage in the field of oral diagnostic imaging modality. It is noninvasive, faster and lacks anatomic superimposition. Earlier maxillary occlusal radiographs were used to assess and evaluate the mid palatal suture, but being a two dimensional imaging modality it could not assess the ossification process which takes place in multiple planes mostly due to curved nature of the palate. In this study we assessed the mid palatal suture morphology and classify them according to the variants using CBCT images. Materials and methods: A total of 200 CBCT scans (95 males and 105 females) were evaluated in the present study from the archives of an imaging center. As per Angelieri classification the midpalatal suture was classified into five categories (A–E) depending on the degree of ossification that had taken place. Statistical analysis was done by Chi Square test using SPSS version 23.0. Results: There is statistically significant difference present in the stages of maturity of mid palatal suture in various age groups with Stage B is most common in Group 1 (50%), Stage C most common in Group 2 (60%) and Group 3 (40%) and Stage E more common in Group 4 (50%). Conclusion: The results of the present study showed a wide variation in the initiation time and the degree of ossification and morphology of the midpalatal suture in different age groups. Although there was an increase in the closure of the suture with aging, age is not a reliable criterion for determining the open or closed nature of the suture. This finding is important in providing an idea as to how diverse is the ossification of maxillary sutures.


2020 ◽  
Vol 8 (3) ◽  
pp. e037
Author(s):  
Mariela Burgos-Urey ◽  
Jhoana Mercedes Llaguno-Rubio

External root resorption (ERR) is a highly prevalent, multifactorial problem frequently associated with orthodontic treatment. Treatment is complex due to the lack of solid knowledge regarding predisposing factors, systematic management for diagnosis and follow-up protocols or thefundamental theoretical bases of adequate imaging tools for each situation. This review describes the indications of the use of cone beam computed tomography (CBCT) and the factors related to its development and the characteristics of the techniques used in the diagnosisand monitoring of ERR in orthodontics. We compared the advantages and disadvantages of CBCT based on the risk/benefits. Methods: We have reviewed and summarized the information and the risk factors available on ERR in orthodontics and the use of CBCT in the diagnosis and follow-up of ERR with the aim of developing a management protocol. Likewise, CBCT is compared with other imaging techniques frequently used in ERR. The articles reviewed in this study coincide in terms of the advantages of precision of CBCT in the detection and linear and volumetric measurement of ERR associated with orthodontics over two-dimensional techniques. However, CBCT cannot completely replace other imaging techniques since its effectiveness is not significantly greater in cases with moderate ERR compromise. The use of CBCT should be optimized following specific criteria for its application. 


Author(s):  
Shirin Sakhdari ◽  
Sara Farahani ◽  
Ehsan Asnaashari ◽  
Sahel Marjani

Objective: This study sought to assess the frequency and severity of second molar external root resorption (ERR) due to the adjacent third molar and its correlation with the position of third molar and other related factors using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study evaluated 320 second molars and their adjacent impacted third molars on CBCT scans of patients over 16 years, retrieved from the archives of Azad University Radiology Department. Presence/absence of second molar ERR, its location and severity (if present), and position of adjacent third molar were determined on CBCT scans, and recorded in a checklist. Data were analyzed using a logistic regression model. Results: The frequency of second molar ERR was 33.4% in the mandible and 14% in the maxilla. The severity of ERR was significantly correlated with the involved jaw (P=0.001) but had no correlation with age, gender, or depth of impaction of adjacent third molar (P>0.05). The mesioangular and horizontal positions of impacted third molars had a significant correlation with the frequency of second molar ERR (P<0.006). Conclusion: According to the results of this study, ERR occurring in second molars adjacent to third molars is common, especially in the mandible. Mesially inclined third molars have a greater potential of being associated with ERR in second molars.


2019 ◽  
Vol 33 (6) ◽  
pp. 691-699 ◽  
Author(s):  
Benjamin J. Talks ◽  
Karan Jolly ◽  
Hanna Burton ◽  
Hitesh Koria ◽  
Shahzada K. Ahmed

Background Cone-beam computed tomography (CBCT) is a fast imaging technique with a substantially lower radiation dosage than conventional multidetector computed tomography (MDCT) for sinus imaging. Surgical navigation systems are increasingly being used in endoscopic sinus and skull base surgery, reducing perioperative morbidity. Objective To investigate CBCT as a low-radiation imaging modality for use in surgical navigation. Methods The required field of view was measured from the tip of the nose to the posterior clinoid process anteroposteriorly and the nasolabial angle to the roof of the frontal sinus superoinferiorly on 50 consecutive MDCT scans (male = 25; age = 17–85 years). A phantom head was manufactured by 3-dimensional printing and imaged using 3 CBCT scanners (Carestream, J Morita, and NewTom), a conventional MDCT scanner (Siemens), and highly accurate laser scanner (FARO). The phantom head was registered to 3 surgical navigation systems (Brainlab, Stryker, and Medtronic) using scans from each system. Results The required field of view (mean ± standard deviation) was measured as 107 ± 7.6 mm anteroposteriorly and 90.3 ± 9.6 mm superoinferiorly. Image error deviations from the laser scan (median ± interquartile range) were comparable for MDCT (0.19 ± 0.09 mm) and CBCT (CBCT 1: 0.15 ± 0.11 mm; CBCT 2: 0.33 ± 0.18 mm; and CBCT 3: 0.13 ± 0.13 mm) scanners. Fiducial registration error and target registration error were also comparable for MDCT- and CBCT-based navigation. Conclusion CBCT is a low-radiation preoperative imaging modality suitable for use in surgical navigation.


2020 ◽  
pp. 105566562094698
Author(s):  
Parviz Padisar ◽  
Maryam Tofangchiha ◽  
Behzad Salari ◽  
Sonia Oveisi

Objective: The purpose of this study was to identify which diagnostic parameters related to impacted maxillary canines can be reliably detected by the conventional orthodontic radiographic modalities and which factors need to be assessed by cone-beam computed tomography (CBCT). Design: In this cross-sectional study, 8 orthodontists evaluated 7 parameters related to the position and anatomy of the impacted canines by means of 2-dimensional (2D) records. After 1 month, the same process was repeated by means of CBCT by the same clinicians. Setting: Qazvin University of Medical Sciences. Patients and Participants: Thirty-two patients with alveolar cleft and impacted maxillary canines who had CBCT scans, lateral cephalograms, and orthopantomographs as pretreatment records. Main Outcome Measure: The diagnostic accuracy of 2D and 3-dimensional (3D) radiographic modalities was compared with each other and also with the gold standard by 3 radiologists. Results: The diagnostic accuracy of 2D and 3D imaging modalities was not significantly different regarding the mesiodistal inclination of the impacted tooth ( P = .09), apex anatomy ( P = .10), and mesiodistal position of the apex ( P = .19). Cone-beam computed tomography had significantly higher diagnostic accuracy than conventional radiographic modalities regarding overlapping the adjacent tooth ( P = .001), labio–palatal and apico–coronal position of the crown tip, and root resorption of the adjacent tooth ( P = .01). Conclusion: The conventional orthodontic radiographic modalities were as accurate as CBCT for determination of impacted canine inclination, apex anatomy, and mesiodistal position of the apex. Cone-beam computed tomography showed higher diagnostic accuracy for other parameters.


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