Orthodontists’ criteria for prescribing cone-beam computed tomography—a multi-country survey

Objectives: Ectopic, impacted, and supplementary teeth are the number one reason for cross-sectional imaging in pediatric dentistry. The accurate post-processing of acquired data sets is crucial to obtain precise, yet also intuitively understandable three-dimensional (3D) models, which facilitate clinical decision-making and improve treatment outcomes. Cinematic rendering (CR) is anovel visualization technique using physically based volume rendering to create photorealistic images from DICOM data. The aim of the present study was to tailor pre-existing CR reconstruction parameters for use in dental imaging with the example of the diagnostic 3D visualization of ectopic, impacted, and supplementary teeth. Methods: CR was employed for the volumetric image visualization of midface CT data sets. Predefined reconstruction parameters were specifically modified to visualize the presented dental pathologies, dentulous jaw, and isolated teeth. The 3D spatial relationship of the teeth, as well as their structural relationship with the antagonizing dentition, could immediately be investigated and highlighted by separate, interactive 3D visualization after segmentation through windowing. Results: To the best of our knowledge, CR has not been implemented for the visualization of supplementary and ectopic teeth segmented from the surrounding bone because the software has not yet provided appropriate customized reconstruction parameters for dental imaging. When employing our new, modified reconstruction parameters, its application presents a fast approach to obtain realistic visualizations of both dental and osseous structures. Conclusions: CR enables dentists and oral surgeons to gain an improved 3D understanding of anatomical structures, allowing for more intuitive treatment planning and patient communication.

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“… 3,4 In particular, complex dental and skeletal conditions call for more informative cross-sectional imaging. 5 …”

Section: Introductionmentioning

confidence: 99%

Cinematic rendering to improve visualization of supplementary and ectopic teeth using CT datasets

Willershausen

Necker

Kloeckner

et al. 2023

Dentomaxillofacial Radiology

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Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study

Zreaqat,

Hassan,

Alforaidi

et al. 2024

Pediatric Pulmonology

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BackgroundRapid maxillary expansion (RME) has been proposed as an effective treatment for pediatric obstructive sleep apnea (OSA) and maxillary restriction in children. This study aimed to evaluate the effect of RME appliances on the nasomaxillary complex dimensions in children with OSA and maxillary constriction.MethodsThis prospective longitudinal study included 34 children aged 8–12 years with maxillary restriction and OSA confirmed by polysomnography who had completed RME therapy. The nasomaxillary complex is segmented into the nasal cavity, maxillary sinuses, and nasopharynx. The effect of RME on nasomaxillary complex dimensions was assessed pre and posttreatment using cone‐beam computed tomography, analysis, while a second standard overnight polysomnography (PSG) was performed to assess changes in respiratory parameters.ResultsSignificant improvements were observed, including inferior maxillary dislocation (S‐S1 distance and N‐ANS), increased anterior and posterior facial height, and a 5.43 events/h reduction in Apnea‐Hypopnea Index (p < .001). The nasal cavity volume increased by 2439 (±584) mm3 (p < .001), nasopharynx size increased by 883 (±479) mm3 (p = .008), mid cross‐sectional area increased by 31.74 (±14.50) mm2 (p < .001), and the distance between the right and left maxillary sinuses increased by 8.37 (±3.67) mm (p < .001) all exhibited positive changes, with some insignificant variations in volume change (p = .254).ConclusionRME treatment was found to be effective in improving nasal cavity and nasopharyngeal dimensions, leading to improved respiratory parameters in children with OSA and maxillary constriction. While these results are promising, considerations about the potential long‐term benefits of RME on future growth are important. The study provides valuable insights into the efficacy of RME as a treatment option for this pediatric population.

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Upper Airway Dimensions among Different Skeletal Malocclusions: A Retrospective Observational Study by Cephalometric Analysis

Sfondrini,

Gallo,

Pascadopoli

et al. 2024

Dentistry Journal

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The aim of the present work was to investigate the upper airway dimensions in adult non-orthodontic patients, equally divided according to their skeletal class. Methods: In this retrospective cross-sectional study, lateral cephalometric radiographs of adult patients referred for orthodontic consultation were collected. Cephalometric tracing was performed with dedicated software. For each measure, descriptive statistics were calculated. Cephalometric measurements between the different skeletal classes were compared. Linear regressions were performed between upper airway diameters and cephalometric measurements, sex and age. Significance was predetermined for p < 0.05. Results: Lateral cephalometric radiographs of 120 patients were reviewed. Nasopharynx length (NL) and depth (PD) measurements were significantly shorter in skeletal class III patients (p < 0.05). The superior pharyngeal airway space (SPAS) was found to be significantly shorter in class III patients as compared to class II patients (p < 0.05), and the mean airway space (MAS) of class I patients was found to be significantly shorter compared to class II patients (p < 0.05). Palate length (PL) values were found to be significantly longer in class I (p < 0.05). Linear regressions showed that the sella-nasion-A point angle (SNA) and Riedel’s angle between point A, the nasion and point B (ANB) significantly influenced NL and PD (p < 0.05). Conclusions: Class III patients show significantly shorter nasopharynx measurements; clinicians should consider that this sagittal discrepancy could be related to an altered anatomy of the upper respiratory tract.

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Orthodontists’ criteria for prescribing cone-beam computed tomography—a multi-country survey

Cited by 5 publications

References 26 publications

Cinematic rendering to improve visualization of supplementary and ectopic teeth using CT datasets

Cinematic rendering to improve visualization of supplementary and ectopic teeth using CT datasets

Effects of rapid maxillary expansion on upper airway parameters in OSA children with maxillary restriction: A CBCT study

Upper Airway Dimensions among Different Skeletal Malocclusions: A Retrospective Observational Study by Cephalometric Analysis

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