CBCT in orthodontics: assessment of treatment outcomes and indications for its use

Abstract

Since its introduction into dentistry in 1998, CBCT has become increasingly utilized for orthodontic diagnosis, treatment planning and research. The utilization of CBCT for these purposes has been facilitated by the relative advantages of three-dimensional (3D) over two-dimensional radiography. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge for some of these applications. This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic therapy and for research to decipher treatment outcomes and 3D craniofacial anatomy. The current diagnostic and treatment planning indications for CBCT include impacted teeth, cleft lip and palate and skeletal discrepancies requiring surgical intervention. The use of CBCT in these and other situations such as root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, asymmetries and alveolar boundary conditions should be justified on the basis of the merits relative to risks of imaging. CBCT has also been used to assess 3D craniofacial anatomy in health and disease and of treatment outcomes including that of root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion; airway morphology, vertical malocclusion and obstructive sleep apnoea; TMJ morphology and pathology contributing to malocclusion; and temporary anchorage devices. Finally, this article utilizes findings of these studies and current voids in knowledge to provide ideas for future research that could be beneficial for further optimizing the use of CBCT in research and the clinical practice of orthodontics.

Conditions and calibration to obtain comparable grey values between different clinical cone beam computed tomography scanners

“…[1][2][3][4][5][6] As the CBCT is an X-ray-based device, the dense materials of hard tissues (i.e. bone and tooth) absorb more radiation energy than soft tissues (i.e.…”

Dental Cone Beam Computed Tomography in Children: Clinical Effectiveness and Cancer Risk due to Radiation Exposure

“…Supernumerary teeth are extra teeth that develop more frequently, but not uniquely, in the anterior maxilla [6]. They can arise singly or multiply, unilaterally or bilaterally, and in one or both jaws; they can be impacted or unerupted.…”

“…Globally, the prevalence of permanent supernumerary teeth ranges from 0.5 to 5.3%, and usually it is difficult to discriminate them from normal teeth [7]. The correct identification of the location of a supernumerary tooth is essential especially if a surgical intervention is required, because it gives extra information on the ideal surgical access to the tooth [5, 6]. It is also of paramount importance to evaluate the root morphology of the supposed supernumerary tooth in detail, as well as its relationship with the adjacent tooth.…”

“…It is also of paramount importance to evaluate the root morphology of the supposed supernumerary tooth in detail, as well as its relationship with the adjacent tooth. In fact, this analysis could influence the decision toward which tooth is required to maintain in the dental arch [6]. In pediatric clinical cases, CBCT can improve the efficiency of diagnosis, the effectiveness of a treatment plan, and the quality of treatment time [5].…”

Cone-beam computed tomography-A boon to dentistry.

“…12 CBCT likely will provide information that could result in one or more of the following outcomes: (1) enhanced diagnosis, such as precisely localizing impacted and supernumerary teeth; (2) quantifying the magnitude of a defect or deformity, such as in patients with craniofacial anomalies; (3) improving differential diagnosis of skeletal, dental or combined malocclusions, including identifying the jaw(s) contributing to malocclusion and determining whether the discrepancy is bilateral or unilateral, such as in orthognathic surgery, asymmetry, craniofacial anomaly and open bite cases; and (4) helping to identify possible causes of malocclusions, such as the contribution of TMJ abnormalities to an open bite or asymmetry. 13 The decision regarding the use of CBCT depends on the severity of malocclusion. The more severe the malocclusion, the more probability of needing the examination and similarly the milder the malocclusion, the less likelihood of needing a CBCT scans.…”