This article aims to discuss current evidence and recommendations for cone-beam
computed tomography (CBCT) in Orthodontics. In comparison to conventional radiograph,
CBCT has higher radiation doses and, for this reason, is not a standard method of
diagnosis in Orthodontics. Routine use of CBCT in substitution to conventional
radiograph is considered an unaccepted practice. CBCT should be indicated with
criteria only after clinical examination has been performed and when the benefits for
diagnosis and treatment planning exceed the risks of a greater radiation dose. It
should be requested only when there is a potential to provide new information not
demonstrated by conventional scans, when it modifies treatment plan or favors
treatment execution. The most frequent indication of CBCT in Orthodontics, with some
evidence on its clinical efficacy, includes retained/impacted permanent teeth; severe
craniofacial anomalies; severe facial discrepancies with indication of
orthodontic-surgical treatment; and bone irregularities or malformation of TMJ
accompanied by signs and symptoms. In exceptional cases of adult patients when
critical tooth movement are planned in regions with deficient buccolingual thickness
of the alveolar ridge, CBCT can be indicated provided that there is a perspective of
changes in orthodontic treatment planning.
The type and width of CLP, the eruption of permanent canines, and the surgeon influenced the outcome of alveolar graft surgeries performed with rhBMP-2.
Root fractures are defined as those that involve cement, dentin and pulp, comprising from 0.5 to 7% of injuries in permanent dentition. Diagnosis is made through clinical and radiographic exams, the latter frequently being limited by the position of the fracture. Treatment varies according to the displacement and vitality of the fragments. The authors present a clinical case of recurrent trauma of tooth 21 causing a horizontal root fracture in the middle third. After several attempts at endodontic treatment, the option was to remove the apical fragment by surgery. The postoperative period of 4 years shows very satisfactory results with regard to wound repair and tooth mobility, or implantation of the coronal segment.
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