Orthodontic Specialty Catalog - 2021/2022 - 61

CUSTOMIZED PRACTICE SOLUTIONS
30 microsieverts. With progress and final records,
that adds up to roughly 90 microsieverts. A 3D dose
is roughly half that. With partial rotation, low settings,
and pulse technology, CBCT can now be taken with
less radiation than a panoramic radiograph. " For
orthodontics, I don't need a 100-micron voxel size full
field of view scan, " said Dr. Burton. " Most of my scans
are taken at 600 microns, which is perfectly acceptable
for orthodontic diagnostics, so [with 3D], I can have all
the information I need with significantly less radiation
exposure for my patients. "
Patient education
In the past, practitioners might show a patient a pan
or a ceph to help explain an issue, but often it was
a struggle for them to understand when they were
just looking at a film on a screen. Using CBCT allows
practitioners to show patients a 3D rendering, and
more easily help them understand the issues and the
treatment options.
Superimpositions and 3D views
With CBCT, the practitioner can view three planes of
space: the axial, the sagittal, and the coronal plane. One
can evaluate the treatment response in all three planes
of space using a true one-to-one superimposition
based on the anterior cranial base.
It's important to take basic software training to learn
how to interact with the CBCT volume. Clinical trainers
are usually available to work hands-on with dental staff
to help them understand not just general interpretation
but how to move through all three planes of space to
evaluate for incidental and pathological findings.
3D workflows
Dr. Burton recommends using a CBCT checklist, which
covers each step in the process, including:
* Orienting the image
* Counting the teeth
* Looking at the condyles
3D offers the ability to:
* Gain more accurate measurements
* Improve localization
* Identify/quantify asymmetries
* Visualize airways
* Assess periodontal structures
* Look at a root proximity and
resorption
* Simulate treatment
* Evaluating the sinuses, spinal column, brain, airway,
and vertebrae
* Checking for cysts in the jaws
* Looking for carotid calcifications, particularly in adult
patients
* Checking for PA lesions or other pathology or
incidental findings
* Checking second and third molars
* Confirming that no teeth are outside the virtual
trough created when the pan was rendered
* Tracing the ceph
* Reviewing the alveolar boundaries
From there, he identifies visual treatment objectives
before determining a diagnosis and treatment plan for
the patient, as described in the case below.
With this patient, there was nothing noteworthy
showing up on the pan or ceph. However, on the MPR
view, it was clear that there were two supernumerary
teeth, which can be clearly seen in the three planes of
space. " If I only had the pan and the ceph, I might have
tried to upright those roots, " said Dr. Burton. " I could
potentially have caused iatrogenic damage to those
teeth as a result of just using a standard MBT or Roth
prescription and putting the brackets on in the correct
position. I could have thrown those roots into the
supernumeraries and potentially caused resorption on
them. So in a case like this, it was absolutely important
that CBCT was used. "
Contact your Henry Schein Representative for more information.
Contact your Henry Schein Representative for more information.
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Orthodontic Specialty Catalog - 2021/2022

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