#DOLPHIN IMAGING CHATSWORTH SERIES#

#DOLPHIN IMAGING CHATSWORTH SERIES#

What specific imaging modality or series of radiographic examinations will provide diagnostically adequate, clinically useful information? Once the decision is made to use dental imaging, choosing the radiographic procedure that provides the necessary information with minimum patient radiographic exposure is next. Justifying every radiographic exposure is never a matter of routine, and involves consideration of the following: patientвЂ™s initial physical presentation as determined by a thorough clinical examination patientвЂ™s chief complaint a comprehensive medical and dental history an analysis of study models review of previous radiographs and identification of preliminary treatment goals based on a working diagnosis.Дў. Will the radiograph complement or supplement the clinical findings? The initial decision to perform radiography is governed by the practitionerвЂ™s need to support a clinical diagnosis or provide additional information to confirm or improve a clinical impression. 1В Determining the potential benefits of a radiographic technique for an orthodontic patient involves consideration of these four sequential questions:ДЎ. The known radiation risks of radiography and CBCT imaging, in particular, are described in part one of this series. For each patient, the potential benefits of the imaging series should be weighed against the risks. The use of radiography in orthodontics should not be considered routine, as it is a modality that involves the use of ionizing radiation-a known carcinogen. This simulated projection panoramic (A), lateral cephalometric (B), radiographic and comparable three-dimensional volumetric panoramic (C), and lateral (D) images are generated from cone-beam computed tomography data. Imaging is also used to compare post-treatment results to the pretreatment predicted outcomes. Imaging in the post-treatment stage is utilized to quantify the immediate outcome of treatment and to monitor the stability of the dentition over time. This is especially important prior to beginning the surgical phase of orthognathic therapy. In the treatment stage, imaging may be used to monitor the effects of therapy on the development of the jaws the position of the teeth, including dental root angulation and the influence of orthopedic and orthodontic therapies on the facial profile. In addition to clinical data, radiographic images assist clinicians in formulating a provisional diagnosis and tentative treatment plan. Information about the relationship of the soft tissue envelope to the underlying hard tissue and the soft tissueвЂ™s role in the development of malocclusion may also be gained. Radiography can assist in determining how the osseous tissue and dental elements contribute to malocclusion or craniofacial anomaly.

At the diagnostic stage, imaging is used as an adjunctive diagnostic modality to provide a pretreatment assessment of the orthodontic patient. Imaging for orthodontic patients serves a number of purposes, depending on the stage of therapy at which it is performed. The final installment of this series will discuss specific indications for CBCT in orthodontics, and will appear in a future issue. This article outlines the role of CBCT imaging in orthodontics, including its advantages.

Increasingly, dental hygienists will be involved in educating patients about the need for CBCT examination, obtaining consent, and taking CBCT scans. In orthodontics, imaging data are integral to the clinical diagnosis of skeletal and dental conditions, soft tissues, and their inter-relationships. The use of cone-beam computed tomography (CBCT) in the dental setting offers low-cost, in-office diagnostic imaging technology capable of demonstrating three-dimensional (3D) dental and skeletal relationships, which far exceed the maxillofacial assessment capabilities of two-dimensional (2D), or traditional, radiography.

List the advantages of using CBCT in orthodontics.

Identify strategies for weighing the benefits of cone-beam computed tomography (CBCT) against its risks in orthodontic patients.

Discuss the role of imaging in orthodontics.

This 2 credit hour self-study activity is electronically mediated.ДЄfter reading this course, the participant should be able to: The authors have no commercial conflicts of interest to disclose. This course was published in the August 2014 issue and August 31, 2017.