February 25, 2017

Cone Beam Computed Tomography in Orthodontics: Indications, by Sunil D. Kapila

By Sunil D. Kapila

Since its advent to dentistry, cone beam computed tomography (CBCT) has gone through a speedy evolution and enormous integration into orthodontics. although, regardless of the expanding acclaim for CBCT and development in utilising it to medical orthodontics, the occupation has lacked a cohesive, accomplished and goal reference that offers clinicians with the history had to make the most of this expertise optimally for treating their sufferers. Cone Beam Computed Tomography in Orthodontics offers well timed, neutral, and state of the art details at the symptoms and protocols for CBCT imaging in orthodontics, medical insights won from those photographs, and ideas pushed by way of those insights. As such, it's the most modern and authoritative textbook on CBCT in orthodontics. Additionally, two DVDs contain greater than 15 hours of video displays on comparable matters from the thirty ninth Annual Moyers Symposium and thirty eighth Annual foreign convention on Craniofacial Research. 

Cone Beam Computed Tomography in Orthodontics is geared up to growth sequentially via particular subject matters with the intention to construct the knowledgebase logically during this vital and quickly evolving box. half I presents the foundational details on CBCT expertise, together with radiation publicity and dangers, and destiny evolutions in computed tomography. half II provides the foundations and Protocols for CBCT Imaging in Orthodontics, targeting constructing evidence-based standards for CBCT imaging, the medico-legal implications of CBCT to the pro and the protocols and integration of this know-how in orthodontic perform. half III offers severe details on CBCT-based prognosis and remedy making plans that incorporates tips on how to interpret CBCT scans, establish incidental pathologies and the prospective different makes use of of this know-how. half IV covers functional features of CBCT’s scientific functions and therapy results that incorporates a diversity of issues, together with root morphology and place, remedy of impacted tooth, digital surgery making plans and results, and more.

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Soft tissues, which have high water content, have HU values that fall between water and dense bone. Because all conventional CT machines are calibrated to ensure that the grayscale measurements on each scan are accurate, all HU measurements taken on conventional CT-generated images can be compared directly with each other. , 2006, 2007; Swennen & Schutyser, 2006). Thus, while a CBCT image can be used to determine if an edentulous site has sufficient alveolar bone thickness to support a dental implant, it cannot be used to determine if the bone density is sufficient to withstand the surgical placement and long-term functional stresses of implant treatment.

Hierarchy of evidence in the use of CBCT Although CBCT clearly enhances the visualization of normal and abnormal anatomy and pathologies, scientific evidence on the impact of the additional information obtained in refining or changing orthodontic treatment plans in several clinical situations remains to be determined. Nevertheless, with increasing clinical utilization and research studies, a hierarchy of indicators for CBCT imaging is emerging. 4; SEDENTEXCT, 2009, 2011; see also Chapter 6). In the absence of such proof, the next level of evidence that can be used to justify use of the technology is provided by published case reports showing its contribution to improved diagnosis, treatment plan or outcome, or any combination of these for a specific type of case, which could be applicable to other similar cases.

Finally, the detection by CBCT of abnormal anatomy of the root, such as dilacerated roots—particularly in the bucco-lingual direction not seen in 2D radiographs—also may help determine the amount and direction that a dilacerated tooth can be moved or may aid in the decision to extract it. Miscellaneous dental anomalies Other dental anomalies that may benefit from CBCT imaging over traditional radiographs include delayed or unerupted teeth and congenitally missing teeth. Alveolar boundary conditions CBCT imaging can help verify alveolar boundary conditions that typically are not observable by 2D radiographs that either may be inadequate prior to treatment or may become compromised during tooth movement.

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