Since its introduction to dentistry slightly over a decade ago, cone beam computed tomography (CBCT) has undergone a rapid evolution and considerable integration into orthodontics. However, despite the rapidly increasing popularity of CBCT and progress in applying it to clinical orthodontics, the profession has lacked a cohesive, comprehensive, and objective reference that provides clinicians with the background needed to utilize this technology optimally for treating their patients. Also, the specific indications and protocols for acquiring CBCT images and extracting appropriate clinical information have not been resolved fully. This textbook provides timely, impartial, and state-of-the-art information on the indications and protocols for CBCT imaging in orthodontics, clinical insights gained from these images, and innovations driven by these insights. As such, it is the most current and authoritative textbook on CBCT in orthodontics.
The book is organized to progress sequentially through specific topics so as to build the knowl-edgebase logically in this important and rapidly evolving field.
• Part 1 on Technology Assessment and Enhancements provides the foundational information on CBCT technology, radiation exposure and risks, the transition from 2D to 3D imaging, and emerging technologies and future evolutions in computed tomography.
• Part 2 contains chapters describing the Protocols and Principles for CBCT Imaging in Orthodontics that focus on developing evidence-based criteria for CBCT imaging, the medico-legal implications of CBCT to the professional, and the protocols and integration of this technology in orthodontic practice.
• Part 3 provides critical information on CBCT-based Diagnosis and Treatment Planning that includes how to interpret CBCT scans and identify incidental pathologies, and the evolving discoveries and possible uses of CBCT to assess the temporoniandibular joint, airway, and dentoalveolar boundary conditions.
• Part 4 covers practical aspects of CBCT's Clinical Applications and Treatment Outcomes and encompasses a range of topics including root morphology and position, impacted and transposed teeth, rapid palatal expansion, outcomes with bone anchored maxillary protraction, temporary anchorage devices, virtual surgical treatment planning and outcomes, facial asymmetries, and craniofacial anomalies.
In reading the book, it will become evident that the insights gained from CBCT are contributing to novel or refined approaches to diagnosis, treatment, and biomechanics planning; assessment of treatment outcomes; and identifying opportunities for novel areas of research. Indeed, future evolutions in CBCT technology and improvements in the clinician's ability to extract and utilize clinically important information contained within the image dataset likely will lead to enhanced treatment outcomes and efficiencies in a broader spectrum of cases than currently possible.
The many authors who contributed to this book include recognized authorities in CBCT and 3D imaging, several of whom also have expertise in specific aspects of orthodontic treatment. They comprise oral maxillofacial radiologists, orthodontists, medical radiologists, engineers, oral and maxillofacial surgeons, and an oral pathologist. In addition to invited manuscripts from these experts, this volume includes chapters and videos of presentations given by well-known authorities in this field at the 39th Annual Moyers Symposium and the 38th Annual International Conference on Cra-niofacial Research (Presymposium). I believe that readers will find this book and accompanying DVDs a valuable resource for the appropriate and optimized application of CBCT to patient care and research. Sunil D. Kapila, BDS, MS, PhD Robert W. Browne Endowed Professor and Chair Department of Orthodontics and Pediatric Dentistry Graduate Orthodontics Program Director School of Dentistry The University of Michigan Ann Arbor, Michigan

List of Contributors ix

Preface xiii

Acknowledgments xv

Part 1 Technology Assessment and Enhancements 3

1 Contemporary Concepts of Cone Beam Computed Tomography in Orthodontics 5

2 Functional and Technical Characteristics of Different Cone Beam Computed Tomography Units 43

3 Cone Beam Computed Tomography in Orthodontics: Perspectives on Radiation Risk 67 4 Rational Basis for Transitioning from 2D to 3D Radiographic Imaging in Orthodontic Practice and Research 81

5 The Future of Cone Beam Computed Tomography and 3D Imaging in Orthodontics 103

Part 2 Protocols and Principles for Cone Beam Computed Tomography Imaging in Orthodontics 113

6 Development of Evidence-Based Selection Criteria for Cone Beam Computed Tomography in Orthodontics 115

7 To Scan or Not to Scan: Medico-Legal Implications 127

8 Protocols for the Use of Cone Beam Computed Tomography in Orthodontic Practice 139

Part 3 Diagnosis and Treatment Planning 165

9 How to Interpret Cone Beam Computed Tomography Scans 167 10 Detection of Incidental Findings in Cone Beam Computed Tomography Imaging and Their Clinical Implications 185

11 3D Orthodontic Diagnosis and Treatment Planning 221

12 Application of 3D TMJ Imaging to TMJDs, TMJ Functional Analyses, and Orthodontic Treatment Outcomes 247

13 Characterization of the Upper Airway Morphology and Its Changes in the Apneic Patient Using Cone Beam Computed Tomography 273

14 Alveolar Boundary Conditions in Orthodontic Diagnosis and Treatment Planning 293

Part 4 Clinical Applications and Treatment Outcomes 317

15 Assessment of Root Position and Morphology by Cone Beam Computed Tomography 319

16 3D Image-Aided Diagnosis and Treatment of Impacted and Transposed Teeth 349

17 Assessment of Maxillary Transverse Deficiency and Treatment Outcomes by Cone Beam Computed Tomography 383

18 Planning and Placing Temporary Anchorage Devices with the Aid of Cone Beam Computed Tomography Imaging 411

19 3D Planning and Treatment Outcomes of Bone Anchored Maxillary Protraction 427

20 Applications of Cone Beam Computed Tomography to Orthognathic Surgery Treatment Planning 437

21 3D Diagnosis and Management of Facial Asymmetries 453

22 3D Assessment of Orthognathic Surgical Outcomes 463

23 3D Imaging in Diagnosis and Treatment Planning of Craniofacial Anomalies 485

Index 509

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