3D Cone Beam CT

Technology has brought orthodontics to a new level of proficiency with a proliferation of advancements including self-ligating brackets, memory + robotically formed wires, oral scanners, cone beam CT, 3D surface imaging, computer aided manufactured appliances, temporary anchorage devices, regional accelerated phenomenon inducing procedures, technologically advanced communication, industry specific imaging and office management software, and more. At the same time, an exponentially increasing knowledge base has opened the doors to a deepening understanding of the complexities of problems that have orthodontic implications and an ever increasing appreciation of the value and scope of orthodontic care as it contributes to quality of life. While each of these advances is significant in itself, there is a synergy in the combination of these developments when taken together.

As our knowledge and capabilities advance to a higher level of complexity, we have both the challenge and opportunity to adopt them into or revise our philosophy of care. This is a profound subject of discussion unto itself. In taking only a simple starting point here, I believe that the core principle which serves as a starting point for minimally invasive dental philosophy of care gives us valuable insight. That is, your most valuable asset is the ability to see. In minimally invasive dentistry this means that magnification loupes and lighting are our most valuable, but not necessarily our most expensive, assets. If we extend that concept to orthodontics today, perhaps even in conceptualizing a philosophy of minimally invasive orthodontics, we could consider cone beam CT as analogous to magnification loupes + lighting. Just like magnification loupes and lighting, cone beam CT opens our eyes to greater clarity and to a higher level of detail giving us the ability to intervene earlier. With cone beam CT our eyes are opened to what could be important, and sometimes critical, information that we otherwise would only see as shadows or not at all. With cone beam CT we can see in three-dimensional virtual reality the developing teeth, the skeletal structure, the supporting bone, the TMJ, the nasal + paranasal sinuses, spatial interrelationships, and early detection of developing pathology. What we see could impact our ability to make clinical correlations, to communicate, to determine our risks, benefits, + alternatives, to coordinate care, and to make therapeutic decisions with our ever more diverse treatment possibilities. If these elements of care are enhanced, the result could be a greater potential to improve our proficiency and our patient’s oral health related quality of life.