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CBCT indications – orthodontic

Orthodontics

When planning orthodontic therapy for different anomalies, a 3D visualization of jaw anatomy can be of great use. It achieves an excellent view of the position and inclination of the teeth and roots, the location and direction of impacted teeth and the relation of the root and the cortical bone. Anatomical structures such as the incisive canal, TMJ, the angle of the mandible, the retromolar space, and general maxilla-mandible relations are much more visible, which provides for an application of 3D diagnostics in planning orthodontic and orthognathic surgery therapy. Apart from that, digital models of the entire jaw can be permanently stored on CDs, which decreases the need for space taken by study or control gypsum casts.

Tooth position
It is possible to determine the inclination and position of roots, periodontal thickness and space, tooth axis and the rotations of individual teeth. In the planning phase, we can accurately identify the equator of every tooth and precisely position the brackets with regards to the desired position. We decrease the need for rebonding and additional bracket positioning. The straight-wire concept reaches its full meaning through accurate planning and root position visualization.

Impacted teeth
With the help of 3D CT devices it is now possible to precisely determine the location of impacted cuspids and molars, their direction, position and relation to adjoining teeth. It is also possible to determine whether resorption of the roots of adjoining teeth has occurred and to what extent. Planning a combined orthodontic-surgical therapy is largely facilitated. Moving the impacted tooth after surgical visualization can be foreseen more precisely and the total orthodontic therapy time can be shortened.

Maxillary sinus
Establishing the relation between the back teeth of the upper jaw and the cortical bone of the sinus floor is important for planning tooth shift.

Incisive canal
When planning a diastema closure or a front teeth torque, it is important to determine the size, shape and position of the incisive canal, since it can block an orthodontic shift.

Arch expansion
Assessments on whether there is enough space in the alveolar bone to perform a tooth arch expansion and whether the patient’s anatomy requires a forced palate expansion can be made more precisely with the help of 3D images.

Cortical bone and tooth eruption disorders
Measuring the size of the alveolar bone is a decisive factor in determining the potential of an orthodontic shift. It is possible that structures exist within the alveolar bone, e.g. corticalization, which would stop tooth shifting during orthodontic treatment. Distances of individual roots from the cortical bone are also easily determined.

Orthognathic pre-surgical treatment and cleft treatment
Planning a combined orthodontic-surgical therapy with 3D diagnostics can significantly speed up the treatment course, enhance communication between specialists and enable a more precise planning of all treatment procedures.

TMJ
It is possible to observe the anatomy of the condyle, articular fossa, atricular eminence, condyle position based on intercuspidation and condyle symmetry.

Retromolar space
3D diagnostics fully enables molar and retromolar space assessment, which is a decisive factor in extracting wisdom teeth or any other teeth in the molar region.

3D cephalometric analyses
3D images enable us to precisely locate cephalometric landmarks and get additional insight into the patient’s craniofacial characteristics.