Orthodontic and orthognathic planning using cone beam computed tomography

Three-dimensional (3D) diagnostic assessment of facial morphology at baseline and overtime has the potential to allow effective and rational clinical decision making for orthodontic and orthognathic surgery patients. This chapter discusses applications of cone beam computed tomography (CBCT) to diagnosis, treatment planning, and approaches to measure changes over time. Current applications of 3D CBCT imaging in orthodontics include evaluation of buccal and lingual plates of the alveolar bone, bone loss or formation, and bone depth and height. Even with the availability of 3D images, there are critical barriers such as radiation from CBCT acquisition, and quantitative measurements, that must be overcome before longitudinal quantitative assessment of the craniofacial complex can be routinely performed. Precise quantitative measurement is required to assess the placement of bones in the desired position, the bone remodeling, and the position of surgical cuts and fixation screws and/or plates relative to risk structures.