The Road to Three-Dimensional Imaging in Orthodontics

doi:10.1053/j.sodo.2010.08.004

Seminars in Orthodontics

Volume 17, Issue 1, March 2011, Pages 2-12

https://doi.org/10.1053/j.sodo.2010.08.004 Get rights and content

This paper examines the origins of 3-dimensional craniofacial measurement. It briefly tracks the development of measurement methods from the plaster casts and facial moulages of the early 20th century to the cone beam computed tomographic scanners of today. The fundamental difference in design between cone beam scanners and conventional computed tomography scanners is described in their difference in primary function; cone beam scanners are optimized for the location of hard tissue structures, such as teeth and bone, whereas computed tomography scanners were originally optimized for the detection of subtle distinctions in the radiopacity of different bodily soft tissues under different conditions of health and disease. The advantages and limitations of several attempts at quantitative measurement of the skull and face in 3 dimensions are noted.

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Citation Excerpt :
One of the biggest controversies with the use of CBCT in dental imaging is the amount of generated radiation. Although there is a lack of definitive data, largely due to the fact that there are almost 60 CBCT scanners available on the market,5 recent reviews signify the importance of generated radiation by CBCT scanning as a cause for concern.6,7 CBCT scanning is often used for investigation of external root resorption because of its ability to produce accurate, anatomically correct images of the root structure.8
The aim was to evaluate image quality produced by a cone-beam CT (CBCT) scanner under various imaging modes. A modulation transfer function (07-538, Nuclear Associates, Carle Place, NY) was placed in an anthropomorphic head phantom (RS-250, Radiology Support Devices, Long Beach, CA). Overall, 67 CBCT scans were obtained by modifying the entire range of kilovolt (kV) and milliampere (mA) settings, using the CS 9300 CBCT scanner (Carestream Health, Inc., Rochester, NY). A total of 24 individual raters rated the images to evaluate line pairs visible. Upon completion of the evaluation process, 4 kV and mA combinations (85 kV × 12 mA, 90 kV × 4.0 mA, 60 kV × 6.3 mA, and 65 kV × 2.5 mA) were selected for further investigation. In all 10 dry skulls were scanned to measure the defect size of simulated root resorption in 4 different modes. Intraclass correlation (ICC) analysis was used to compare the agreement between the defect sizes measured from the scans compared to the actual physical volume. Low kV settings (60 kV) used in combination with moderate-to-high mA settings (4.0–15 mA) produced the best-perceived image quality, resulting in up to 56% reduction in the total radiation amount (mGy cm²) generated. High kV settings (85–90 kV) used in combination with high mA settings (8.0–15 mA) produced the lowest image quality. All 4 selected imaging modalities presented a high level of accuracy in detection of root resorption volume compared to actual physical volume (ICCs between 0.93 and 0.98). Radiation exposure from CBCT scans can be reduced while maintaining adequate image quality and diagnostic accuracy by performing scans using low kV and moderate-to-high mA settings.
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View full text

The Road to Three-Dimensional Imaging in Orthodontics

J Am Dent Assoc

J Prosthet Dent

Am J Orthod

Am J Orthod

Three-dimensional diagnosis and treatment in orthodontics

Semin Orthod

New method in dento-facial orthopaedia

Dental Cosmos

Fundamental Principles of a Systematic Diagnosis of Dental Anomalies

Gnathology—A Research Report

Death and Dentistry

A new x-ray technique and its application to orthodontia

Angle Orthod