Impact of cone-beam computed tomography on orthodontic diagnosis and treatment planning
Impact of cone-beam computed tomography on orthodontic diagnosis and treatment planning
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DOI：
10.1016/j.ajodo.2012.12.011
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发表时间：
2013-05-01
影响因子：
3
通讯作者：
White, Stuart C.
中科院分区：
文献类型：
--
作者：
Hodges, Ryan J.;Atchison, Kathryn A.;White, Stuart C.
前言：在这项研究中，我们测量了锥束计算机断层扫描(CBCT)对正畸诊断和治疗计划的影响。方法：有6名患者的传统正畸记录的参与者正畸医生被要求提供诊断问题清单、假想的治疗计划和临床确定性。然后，他们评估了每个患者的CBCT扫描，并记录了诊断和治疗计划的任何变化、确认或增强。结果：诊断和治疗计划的数量随患者特征的不同而变化很大。最常报告的诊断和治疗计划改变发生在牙齿未萌出、严重的牙根吸收或严重的骨骼不一致的患者。我们发现，当患者接受CBCT扫描的原因是检查颞颌关节或呼吸道的异常或拥挤时，在改变治疗计划方面没有任何好处。拥有CBCT机器或在实践中频繁使用CBCT扫描的正畸参与者报告称，在研究期间观看CBCT扫描后，诊断和治疗计划的变化明显更多，信心更强。结论：本研究的结果支持在正畸诊断和治疗计划之前获得CBCT扫描，当患者的未萌出牙有延迟萌出或位置可疑，根尖周或全景片诊断为严重的牙根吸收，或严重的骨骼不一致时。我们建议，只有当有明确的、特定的、个别的临床理由时，才应该进行CBCT扫描。(Am J Orthod DentofaceOrthop 2013；143：665-74)
Introduction: In this study, we measured the impact of cone-beam computed tomography (CBCT) on orthodontic diagnosis and treatment planning. Methods: Participant orthodontists shown traditional orthodontic records for 6 patients were asked to provide a diagnostic problem list, a hypothetical treatment plan, and a clinical certainty. They then evaluated a CBCT scan for each patient and noted any changes, confirmations, or enhancements to their diagnosis and treatment plan. Results: The number of diagnosis and treatment plan changes varied widely by patient characteristics. The most frequently reported diagnosis and treatment plan changes occurred in patients with unerupted teeth, severe root resorption, or severe skeletal discrepancies. We found no benefit in terms of changes in treatment plan for patients when the reason for obtaining a CBCT scan was to examine for abnormalities of the temporomandibular joint or airway, or crowding. Orthodontic participants who own CBCT machines or use CBCT scans frequently in practice reported significantly more diagnosis and treatment plan changes and greater confidence after viewing the CBCT scans during the study. Conclusions: The results of this study support obtaining a CBCT scan before orthodontic diagnosis and treatment planning when a patient has an unerupted tooth with delayed eruption or a questionable location, severe root resorption as diagnosed with a periapical or panoramic radiograph, or a severe skeletal discrepancy. We propose that CBCT scans should be ordered only when there is clear, specific, individual clinical justification. (Am J Orthod Dentofacial Orthop 2013;143:665-74)