Equipment & Technology Orthodontic Catalog - 2020 - 2

CUSTOMIZED PRACTICE SOLUTIONS

Is Your 2D "Just Okay"
3D Imaging: 2D v. 3D in Orthodontics
Jay B. Burton, DMD, MBA
An increasing number of orthodontists are embracing

lateral photo. "With CBCT, you are treating more of

3D - changing the way that they practice and the

the patient's individual anatomy," said Dr. Burton.

way they develop treatment plans. This technology

"There are 3D analyses out there from places like Case

significantly enhances diagnostic capabilities,

Western Reserve University, but you'll find yourself

improving the patients' end result. "We're looking not

less dependent upon those and more dependent upon

only at improved treatment plans but an improved

the evaluation of the patient's individual anatomy."

ability to evaluate our own work at the end of
treatment with superimpositions," said

"One of the great benefits of CBCT is the ability to

Dr. Jay B. Burton, a member of the AAO, Southern

evaluate the alveolar boundaries ("aka" limitations)

Association, Tennessee and Kentucky Associations of

while diagnosing and treatment planning the case.

Orthodontics. "This is not only in the sagittal plane,

You're able to look very closely and determine how

but in the coronal and the axial planes as well."

much bone is around a tooth to decide whether or not
you can move that tooth. That tells you what type of

Why CBCT in orthodontics?

torque you need, and what type of tip you need to

CBCT provides a true 3D representation of the

plan your prescription on your brackets better."

patient's dentoalveolar facial structures. 3D renderings
offer a true one-to-one image that supports accurate

Lower radiation for patients

superimpositions.

Previously, the biggest risk with CBCT was the
radiation dose. However, with the advent of ultra

2

Any view of the patient's CBCT can be rendered

low-dose imaging it is now possible to image a patient

- including lateral cephs, PA cephs, and

in 3D with less radiation than with a traditional 2D

submentovertex, all in one volume instead of taking

radiography. For example, a poster by Ludlow and

multiple images. When rendering pan views in 3D

Koivisto involving the University of North Carolina and

versus 2D, for example, the practitioner can not only

the University of Helsinki showed that they were able

count the teeth and see an overview of dentition but

to decrease the radiation dose by as much as 77%

see the molar class and the midline.

while still maintaining image quality.

Another advantage of CBCT is the ability to

The radiation dose is dependent on many variables,

coordinate work with medical colleagues using

such as:

DICOM-formatted images. Practitioners can also use

* The indication/diagnostic purpose of the scan

the 3D data to model treatment, to model appliances,

* The field of view needed

and to educate patients on what to expect from

* The mA and KvPs needed to obtain a quality image

their treatment.

* The resolution needed

Improved diagnostics

As a rule of thumb, a 2D pan is generally around

With a rendered ceph, the practitioner can reorient

25 microsieverts, and a 2D ceph for initial records

based on the natural head position, using the patient's

is about ~5 microsieverts, for a total of about 30

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Equipment & Technology Orthodontic Catalog - 2020

Table of Contents for the Digital Edition of Equipment & Technology Orthodontic Catalog - 2020
