Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, 1011 North University Avenue, Ann Arbor, MI 48109-1078, USA.
Dentomaxillofac Radiol. 2011 Jan;40(1):24-34. doi: 10.1259/dmfr/12615645.
Cone beam CT (CBCT) has become an increasingly important source of three dimensional (3D) volumetric data in clinical orthodontics since its introduction into dentistry in 1998. The purpose of this manuscript is to highlight the current understanding of, and evidence for, the clinical use of CBCT in orthodontics, and to review the findings to answer clinically relevant questions. Currently available information from studies using CBCT can be organized into five broad categories: 1, the assessment of CBCT technology; 2, its use in craniofacial morphometric analyses; 3, incidental and missed findings; 4, analysis of treatment outcomes; and 5, efficacy of CBCT in diagnosis and treatment planning. The findings in these topical areas are summarized, followed by current indications and protocols for the use of CBCT in specific cases. Despite the increasing popularity of CBCT in orthodontics, and its advantages over routine radiography in specific cases, the effects of information derived from these images in altering diagnosis and treatment decisions has not been demonstrated in several types of cases. It has therefore been recommended that CBCT be used in select cases in which conventional radiography cannot supply satisfactory diagnostic information; these include cleft palate patients, assessment of unerupted tooth position, supernumerary teeth, identification of root resorption and for planning orthognathic surgery. The need to image other types of cases should be made on a case-by-case basis following an assessment of benefits vs risks of scanning in these situations.
自 1998 年 CBCT（锥形束 CT）引入牙科领域以来，它已成为临床正畸学中越来越重要的三维（3D）容积数据来源。本文旨在强调 CBCT 在正畸中的临床应用的现有理解和证据，并回顾研究结果以回答临床相关问题。目前，使用 CBCT 的研究可提供的信息可以分为以下五类：1. CBCT 技术评估；2. 颅面形态学分析中的应用；3. 偶然和漏诊发现；4. 治疗效果分析；5. CBCT 在诊断和治疗计划中的疗效。总结了这些专题领域的发现，然后介绍了在特定情况下使用 CBCT 的当前适应证和方案。尽管 CBCT 在正畸中的应用越来越普及，并且在某些情况下优于常规射线照相，但这些图像提供的信息对改变诊断和治疗决策的影响尚未在某些类型的病例中得到证明。因此，建议在常规射线照相不能提供满意的诊断信息的情况下，在特定病例中使用 CBCT；这些病例包括腭裂患者、未萌出牙齿位置评估、多生牙、牙根吸收的识别和正颌手术计划。在这些情况下，应根据扫描的获益与风险评估，逐个病例进行成像的必要性评估。
