Why Is Cone Beam CT (CBCT) Critical in Performing a Comprehensive Orthodontic Examination?
"The best outcomes come from the most thorough diagnosis." Dr. David Hatcher—Leading Oral Radiologist
When imaging a patient, you must have diagnostic goals:
If long-term oral health is at or near the top of your list, then it is essential that the health of the TM joints, root positions in bone, and airways be critically evaluated as well as all of the other necessary factors.
CBCT, a form a digital cranial imaging, is the “gold standard” for evaluating jaw joints and airways and screening for pathology. CBCT gives 2 and 3 dimensional images of all of the structures. It also allows us to view structures that would otherwise not be as visible with conventional radiography.
CBCT will very accurately show us the position of the ball in the socket, joint space, and all of the articulating surfaces. We can then tell if there has been a change in shape of any of the components of the jaw joints and very specifically if there is any beginning changes that we can address before there is a major problem. In addition, if there is a more significant problem, then the more accurate, digital images of the jaw joints and cranium will ensure that the most appropriate treatment modalities may then be implemented.
Jaw joint changes on one side only in a child with no symptoms. Measures were taken to prevent further breakdown of the joint in this young patient. This would not have been found without CBCT.
CBCT utilized to evaluate airways pre and post treatment in the child and adult patient.
Airway volume and minimal axial area prior to and following rapid palatal expansion in a child with airway difficulties.
Airway volume and minimal cross sectional areas pre and post jaw surgery in an adult with severe obstructive sleep apnea. Note the facial changes as well.
CBCT is the primary way a clinician can accurately evaluate the position of roots in bone. If our long term goal includes gum and bone health, then we need to be able to evaluate root positions prior to starting treatment and prior to determining if we are ready to remove appliances. Does the smile just look great or does the smile look great and will it be a healthy for a lifetime? View the following three images.
Traumatic Bone Cyst and Impacted Canine