cbct // feature
by Jack Fisher, DMD
The advent of 3D imaging technology has raised a debate: does
CBCT imaging significantly benefit patients or aid in the diagnosis and treatment planning of patients?
With the older CBCT models, radiation was certainly a concern. N ow, with low-dose machines like the new unit from P lanmeca, radiation is delivered at a dose of 14ms. This takes a full scan
at 600 um, which undermines the radiation argument.
The specialty of orthodontics has had a recent infl ux of technology. From intraoral scanners and digital impressions to 3D
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printers replacing plastic models, it seems we need to decide how to
best use this technology for the benefit of our patients. We should
be judicious with technology and use it to benefit, not to overtreat.
H ere are 10 patients on whom you should take a CBCT scan.
1. The Patient with Impacted Maxillary Canines
Only 1-2 percent of the population has impacted canines. If
impacted canines are the main reason for taking DICOM, imaging may be better to outsource, as purchasing a machine for such
a small percentage of the population isn' t cost effective. A 2D pan
or ceph will not adequately image the impacted teeth for surgical
planning or for treatment planning.
It has been reported that 62 percent of paletally impacted
canines are touching the roots of laterals and centrals. This is
information that 3D imaging illustrates. This information can
change the mechanics needed to properly position the canines
without damaging the roots of adjacent teeth.
3D imaging of impacted teeth is certainly advantageous to the
orthodontist or oral surgeon who will surgically expose the nonerupted teeth. The doctor can readily see the benefits to the patient
for using the 3D imaging technology for this treatment (Figs. 1a-c).
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SEPTEMBER 2014 // orthotown.com
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Table of Contents for the Digital Edition of Orthotown September 2014