19 Jun 10 Reasons Your Orthodontist Might Recommend 3D Imaging
Most everyone I know has undergone some kind of X-ray—in the hospital ER, at a doctor’s office, urgent care center—probably most often at the dentist’s office. Who doesn’t love that folded cardboard dental film or the goopy goop required for a full-mouth impression mold? For orthodontic patients, in particular, imaging is crucial since provides valuable additional data about skeletal and dental conditions, soft tissues, airway obstruction, and their interrelationships.
For decades, this imaging has typically involved 2D cephalometric and panoramic X-rays, along with 2D facial and intraoral photographs. Unfortunately, 2D imaging does not depict a patient’s dental and facial structures in true three-dimensional form. That changed with the introduction of 3D imaging technology such as Cone Beam CT (CBCT) and 3D surface scans of the face and/or teeth.
In simple terms, CBCT is a compact, faster and safer version of a regular CT. Using a cone-shaped X-ray beam, the size of the scanner, radiation dosage and time needed for scanning are all dramatically reduced. Unlike traditional 2D imaging, 3D CBCT takes cross-sectional image “slices” that offer clear images of soft tissue, bone, muscle, and blood vessels, without sacrificing clarity. Armed with that information, practitioners can arrive at what we call ‘anatomical truth,’ which is key to creating an accurate diagnosis and treatment plan.
Despite its widespread use in the medical field, many orthodontic patients are unaware of the benefits of using 3D CBCT, so when their practitioner recommends it, they are sometimes skeptical about whether this technique is necessary. Here are 10 reasons your orthodontist may suggest 3D CBCT imaging for you or your child.
1. Clinical Imaging Efficiency
CBCT imaging captures images of a patient’s entire maxillofacial skeleton in a single procedure. Data from the images can be reformatted to create simulated images that can support more efficient diagnosis and treatment.
2. Anatomic Accuracy
Unlike traditional 2D X-rays, CBCT images are almost anatomically true (1:1 in size) representations, enabling practitioners to obtain actual measurements without compensating for magnification or projection discrepancies. error.
3. Airway Problems
3D CBCT imaging helps orthodontists find problems related to airway constriction, including nasal polyps, sinus infections, sinus defects, and tonsil and adenoid problems that cannot be seen easily—if at all—using traditional 2D techniques. This is especially useful when treating children, as the airway affects their growth and development. Airway issues are also a root cause of sleep-disordered breathing, including Obstructive Sleep Apnea (OSA). In addition to interrupting healthy sleep, OSA can lead to serious chronic health problems such as high blood pressure, Type 2 diabetes, stroke, obesity, and cardiovascular disease.
4. Jaw Disease
CBCT imaging gives a true picture of the location, size, shape, extent and full involvement of conditions in a patient’s jaw, including infections, benign cysts, and tumors. Any of these conditions could require surgery before orthodontic therapy.
5. Identifying/Explaining Incidental Findings
In orthodontics, CBCT often provides a higher prevalence of incidental findings—observations that appear unrelated to the scan’s original purpose but may or may not be important.
Uncovering these findings can be important, and they routinely go undetected with traditional 2D imaging; for example, airway obstruction and jaw misalignment that can lead to sleep and breathing issues. Research has shown that many behavior problems in children, such as ADD, ADHD, aggression, and bedwetting can be tied to sleep-disordered breathing and obstructive sleep disorders. 3D CBCT imaging helps practitioners look beyond the obvious when diagnosing a patient’s condition
6. Oral Appliance Design
Many orthodontic treatment plans include the use of oral appliance therapy. Designing these appliances requires a thorough understanding of both biological and physical variables. The ability to create 3D maxillofacial virtual “solid” structures from CBCT data allows clinicians to create an appliance that meets each patient’s individual treatment needs.
7. Treatment Success Over Time
3D imaging helps orthodontists predict changes in bony or soft tissues associated with treatment, over time. By understanding how well braces, oral appliances, and other therapies are working throughout the treatment plan, practitioners can make adjustments along the way to ensure a truly successful outcome.
About 15-20 percent of my patients seeking orthodontic treatment, including children, have signs and/or symptoms of TMJ before we start treatment. With one scan from a cone beam, I not only have information on the skeletal and dental relationships, but I can also assess the conditions of the TM joints, the airway, and the cervical/spinal area.
9. Impacted Teeth
In orthodontics, impacted teeth are a challenge not only for the surgeon but also for the orthodontist, who is trying to make space and guide teeth past adjacent roots into proper alignment. Knowing this information has an obvious impact on the surgical procedure by allowing the oral surgeon to plan precisely. 3D imaging eliminates the need for exploratory surgery to determine this information.
10. Microimplant Placement
Microimplants are used in connection with temporary anchorage devices (TAD) to aid orthodontic tooth movement. Cross-sectional images of the micro-implant site and the rendered 3D images help orthodontists and oral surgeons decide where to place the TADS for optimum tooth movement.
Is your dentist or orthodontist recommending 3D imaging? If so, ask him or her to fully explain why. If you’d like to learn more about this breakthrough technology, I highly recommend visiting www.conebeam.com, where you will find a huge amount of information and resources. Be an informed health care consumer!