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Articles

Update on 2D and 3D digital imaging in orthodontics

Jonathan Davies Anne Harwood Eric Whites

From Volume 4, Issue 1, January 2011 | Pages 6-13

Authors

Jonathan Davies

BDS, MFDS RCS, MSc, DDR RCR

Consultant in Dental and Maxillofacial Radiology

Articles by Jonathan Davies

Anne Harwood

BSc, BDS, MFDS RCS, MSc, DDR RCR

Specialist Registrar in Dental and Maxillofacial Radiology

Articles by Anne Harwood

Eric Whites

BDS, MSc, FDS RCS(Edin) FDS RCS(Eng), FRCR DDR RCR

Senior Lecturer/Honorary Consultant in Dental and Maxillofacial Radiology, King's College London Dental Institute, Department of Dental and Maxillofacial Radiological Imaging, Floor 23, Tower Wing, Guy's Hospital, London, UK

Articles by Eric Whites

Abstract

This article provides an update on two-dimensional (2D) and three-dimensional (3D) imaging in contemporary orthodontics. The use of computed radiography (CR) and direct digital radiography (DR) for two-dimensional intra- and extra-oral imaging are outlined and compared. The advantages and disadvantages of each approach are discussed and various common imaging faults that may be produced are illustrated. 3D Cone-beam computed tomography (CBCT) image production is presented and discussed with consideration to patient dose and its applications in orthodontics. The current SEDENTEX CT guidelines for the appropriate use of this imaging modality are also outlined.

Clinical Relevance: As radiographic imaging is an integral aspect of clinical orthodontics understanding modern 2D and 3D imaging techniques is essential to maximize the benefits and minimize the risks to patients.

Article

Orthodontic treatment planning is primarily based on a thorough clinical examination, with radiographs being regarded as the orthodontist's main diagnostic aid. However, the range of radiographic imaging available, and how images are obtained, has changed considerably in recent years with the development of two-dimensional digital imaging and, more recently, with three-dimensional digital imaging. This article provides an overview of these digital imaging developments and their advantages and disadvantages as diagnostic aids in clinical orthodontics. Selection criteria for conventional radiographs in orthodontics will not be covered as these are available in the British Orthodontic Society's Guidelines for the Use of Radiographs in Clinical Orthodontics 3rd edition.¹ However, brief reference is made to current guidance on the clinical use of 3D imaging.

Commonly used 2D orthodontic radiographs include:

Image acquisition for all of these views requires X-ray generating equipment (dental or panoramic) and some form of digital image receptor. The X-ray generating machines used in digital imaging are essentially identical to those that have been used traditionally in dentistry to create film-based images. The major development in imaging has resulted from changing the image receptor. Digital imaging receptors may be one of two types:

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