Background This study aimed to compare two-dimensional radiographs and cone beam computed tomography (CBCT) images for mini-implant planning. Material and Methods A search was performed in PubMed, Embase, Web of Science, Cochrane Library and Google Scholar electronic databases according to PIRD strategy, on September 11, 2021. In vivo studies that compared two-dimensional imaging with CBCT for mini-implant planning were selected. The methodological quality of each study was assessed using the QUADAS-2 tool. Results The initial search identified 441 papers. Five studies were added following a manual research. Of the total 446 studies, 40 were selected after title evaluation, 29 remained after abstract evaluation, and 11 were left after full-text analysis. Final screening yielded a total of four studies that composed the narrative synthesis of this systematic review. When comparing the imaging systems for palatal mini-implants, lateral radiographs (LRs) showed approximately the same measurements of bone quantity as those of CBCT, hence bearing no influence on placement site selection. In determining image suitability for interradicular mini-implants, two-dimensional radiographs underestimated the available space. Conclusions Lateral radiography is sufficient to quantify the available bone for planning mini-implants installed on the palate, in the median region of upper first premolars. CBCT enhances interradicular mini-implant planning by aiding in implantation site selection, and improving the installation success rate. Key words: Systematic Review, Cone beam computed tomography, Radiography, Orthodontic mini-implant, Dental planning.
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