CONE BEAM COMPUTED TOMOGRAPHY AS AN ADDITIONAL METHOD OF EXAMINATION IN ORTHODONTIC PATIENTS

Abstract

Today, the diagnosis of orthodontic patients is carried out according to the generally accepted method using orthopantomogram, lateral and direct cephalogram with their subsequent analysis, as well as linear and angular measurements of various parameters.
 However, the reliability of the diagnosis depends quite strongly on the position of the head on 2D radiography, as the need to obtain additional radiographs depends on this, because there are significant limitations due to summation overlays, two-dimensional flattening and variable magnification of various anatomical structures of the facial skull.
 The emergence of cone beam computed tomography (CBCT) technology made it possible to display, study and analyze anatomical structures of the facial skull in thin sections in all three planes, as well as to obtain three-dimensional reconstructions of skeletal and soft tissue structures of the face using a lower dose of radiation than multispiral computer computed tomography (MSCT), but still higher compared to twodimensional cephalography.
 Since children and adolescents predominate among orthodontic patients, it is necessary to pay attention that the received effective dose of irradiation, under equal conditions, is 36% higher in children than in adults, and with age there is a sufficiently large risk of developing stochastic effects. Therefore, radiation protection, in case of appointment of CBCT by an orthodontist, is extremely important.
 There are various indications for CBCT of the entire skull in children and adolescents, which are limited by complex clinical situations, such as: skeletal asymmetries or genetic malformations, etc. For pediatric orthodontic patients, the indications for CBCT of the limited field of view are the evaluation of: dystopian and retentive teeth, evaluation of compact jaw plates, volume of the upper respiratory tract, anatomy and anomalies of the development of the jaws, together with the maxillary sinuses and temporomandibular joints (TMJ) and others.
 The use of CBCT as an additional diagnostic method in orthodontic practice has had a greater impact on the planning and quality of patient treatment.