Tomografia computadorizada de feixe cônico (Cone beam): entendendo este novo método de diagnóstico por imagem com promissora aplicabilidade na Ortodontia

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Abstract

OBJETIVO: este artigo visa informar e atualizar o profissional da área odontológica a respeito da tomografia computadorizada, incluindo informações concernentes à aquisição de imagens, dose de radiação e interpretação do exame tomográfico, com distinção entre a tomografia computadorizada tradicional e a tomografia computadorizada de feixe cônico. Adicionalmente, as possibilidades de aplicação deste método de diagnóstico por imagem na Ortodontia são discutidas. CONCLUSÕES: resultado de avanços tecnológicos, da redução da exposição à radiação e da ótima qualidade da imagem, as expectativas apontam para uma utilização mais abrangente da tomografia computadorizada de feixe cônico na Odontologia e na Ortodontia. Com a definição de novos conhecimentos gerados pela visão tridimensional do crânio e da face, o futuro reserva a renovação de conceitos e paradigmas, assim como a redefinição de metas e planos terapêuticos ortodônticos.

Translated abstract

OBJECTIVES: This article aims to inform and update the dental professional regarding computed tomography (CT), including information related to image acquisition, radiation dose and CT interpretation, with distinction between the traditional CT and the cone beam CT. Additionally, the possibilities of application of CT in Orthodontics are discussed. CONCLUSION: As a result of technological advances, lower radiation dose and optimal image quality, the expectations point to a more wide utilization of cone beam computed tomography in Dentistry and Orthodontics. With the definition of new knowledge generated from the three-dimensional view of cranium and face, the future can bring changes in concepts and paradigms as well as the redefinition of orthodontic objectives and treatment plans.

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A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results.

C Procacci, A Tacconi, Ivo Andreis … (1997)

The objective of this paper is to present a new type of volumetric CT which uses the cone-beam technique instead of traditional fan-beam technique. The machine is dedicated to the dento-maxillo-facial imaging, particularly for planning in the field of implantology. The main characteristics of the unit are presented with reference to the technical parameters as well as the software performance. Images obtained are reported as various 2D sections of a volume reconstruction. Also, measurements of the geometric accuracy and the radiation dose absorbed by the patient are obtained using specific phantoms. Absorbed dose is compared with that given off by spiral CT. Geometric accuracy, evaluated with reference to various reconstruction modalities and different spatial orientations, is 0.8-1% for width measurements and 2.2% for height measurements. Radiation dose absorbed during the scan shows different profiles in central and peripheral axes. As regards the maximum value of the central profile, dose from the new unit is approximately one sixth that of traditional spiral CT. The new system appears to be very promising in dentomaxillo-facial imaging and, due to the good ratio between performance and low cost, together with low radiation dose, very interesting in view of large-scale use of the CT technique in such diagnostic applications.

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Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation.

José Henriques, Daniela Garib, Roberto De Masi … (2006)

The force delivered during rapid maxillary expansion (RME) produces areas of compression on the periodontal ligament of the supporting teeth. The resulting alveolar bone resorption can lead to unwanted tooth movement in the same direction. The purpose of this study was to evaluate periodontal changes by means of computed tomography after RME with tooth-tissue-borne and tooth-borne expanders. The sample comprised 8 girls, 11 to 14 years old, with Class I or II malocclusions with unilateral or bilateral posterior crossbites Four girls were treated with tooth-tissue-borne Haas-type expanders, and 4 were treated with tooth-borne Hyrax expanders. The appliances were activated up to the full 7-mm capacity of the expansion screw. Spiral CT scans were taken before expansion and after the 3-month retention period when the expander was removed. One-millimeter thick axial sections were exposed parallel to the palatal plane, comprising the dentoalveolar area and the base of the maxilla up to the inferior third of the nasal cavity. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal alveolar bone crest level by means of the computerized method. RME reduced the buccal bone plate thickness of supporting teeth 0.6 to 0.9 mm and increased the lingual bone plate thickness 0.8 to 1.3 mm. The increase in lingual bone plate thickness of the maxillary posterior teeth was greater in the tooth-borne expansion group than in the tooth-tissue-borne group. RME induced bone dehiscences on the anchorage teeth's buccal aspect (7.1 +/- 4.6 mm at the first premolars and 3.8 +/- 4.4 mm at the mesiobuccal area of the first molars), especially in subjects with thinner buccal bone plates. The tooth-borne expander produced greater reduction of first premolar buccal alveolar bone crest level than did the tooth-tissue-borne expander.

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"Safe zones": a guide for miniscrew positioning in the maxillary and mandibular arch.

Cristina Incorvati, Paola Poggio, Stefano Velo … (2006)

The aim of this study was to provide an anatomical map to assist the clinician in miniscrew placement in a safe location between dental roots. Volumetric tomographic images of 25 maxillae and 25 mandibles taken with the NewTom System were examined. For each interradicular space, the mesiodistal and the buccolingual distances were measured at two, five, eight, and 11 mm from the alveolar crest. In this article, measurements distal to the canines are presented. In the maxilla, the greatest amount of mesiodistal bone was on the palatal side between the second premolar and the first molar. The least amount of bone was in the tuberosity. The greatest thickness of bone in the buccopalatal dimension was between the first and second molars, whereas the least was found in the tuberosity. In the mandible, the greatest amount of mesiodistal dimension was between first and second premolar. The least amount of bone was between the first premolar and the canine. In the buccolingual dimension, the greatest thickness was between first and second molars. The least amount of bone was between first premolar and the canine. Clinical indications for a safe application of the miniscrews are provided, as well as the ideal miniscrew features.

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Author and article information

Contributors

Daniela Gamba Garib: Role: ND

Rubens Raymundo Jr.: Role: ND

Melissa Vasconcellos Raymundo: Role: ND

Denys Vasconcellos Raymundo: Role: ND

Sandrina Niza Ferreira: Role: ND

Journal

Journal ID (publisher): dpress

Title: Revista Dental Press de Ortodontia e Ortopedia Facial

Abbreviated Title: Rev. Dent. Press Ortodon. Ortop. Facial

Publisher: Dental Press Editora (Maringá )

ISSN: 1980-5500

Publication date (Print): April 2007

Volume: 12

Issue: 2

Pages: 139-156

Affiliations

[1 ] Universidade Cidade de São Paulo Brazil

[2 ] PROFIS

[3 ] Prevodonto

[4 ] Universidade do Estado do Rio de Janeiro Brazil

[5 ] Universidade do Estado do Rio de Janeiro Brazil

[6 ] Universidade Veiga de Almeida

[7 ] Clínica RORRJ

Article

Publisher ID: S1415-54192007000200018

DOI: 10.1590/S1415-54192007000200018

SO-VID: 04bc72c0-701c-454a-be29-9a512fcc9d47

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http://creativecommons.org/licenses/by/4.0/

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Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1415-5419&lng=en

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Most cited references 63

A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results.

Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation.

"Safe zones": a guide for miniscrew positioning in the maxillary and mandibular arch.

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