Pacific Coast Society of Orthodontists Bulletin Summer 2015 - (Page 16)

Special Section CBCT Program Talk CBCT Cone-Beam Computed Tomography PCSO Program Talk 2015 Dr. Alyssa Levin Phoenix, AZ The controversy over cone-beam computed tomography (CBCT) in clinical orthodontics remains hot, showing no signs of immediate consensus. The ALARA principle (As Low As Reasonably Achievable) and/or its application in clinical practice seems to be at the heart of the matter, given the relatively young average age of the patients we serve. Of particular interest is the use of CBCT as the imaging protocol of choice for comprehensive orthodontic treatment. This summer, Program Talk aims to gauge the current temperature of CBCT imaging protocols within PCSO residency programs. Orthodontic residency programs often are at the forefront of implementing new technologies, with manufacturers eager to expose the next generation of orthodontists to their products. From a practical standpoint, replacing CBCT units to keep pace with improvements in dosimetry is cost-prohibitive. It may be that newer machines (e.g., i-CAT FLX1) mute the radiation exposure argument somewhat, but it is still incumbent on clinicians to use their settings (field of view, exposure time, voxel size) appropriately. All PCSO programs (N=12) have access to at least one CBCT machine, although makes and models vary widely. As you read through the programs' responses (N=11), keep in mind that the machine itself must necessarily inform the program's philosophy and influence patterns of use. Most programs do not require pre-treatment CBCT scans (n=8). Of those that do (n=3), two have exceptions such as early treatment, limited treatment, and routine Class I malocclusions. Although the majority of programs do not currently espouse the use of CBCT as the imaging protocol of choice for comprehensive orthodontic treatment, the consensus appears to be that it will only be a matter of time (n=9). Didactic and clinical curriculum training requirements also vary widely, with programs reporting as few as four and as many as 60 hours devoted to CBCT imaging concepts. Either a radiology technician (n=9) or a trained dental auxiliary (n=2) perform these scans. Of interest, an oral and maxillofacial radiologist is the only party responsible for reading CBCT volumes in almost 50% of programs (n=5). Figure 1. Images provided courtesy of the Arizona School of Dentistry & Oral Health, Postgraduate Orthodontic Program. See text for details. 16 PCSO Bulletin  Summer 2015

Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Summer 2015

Staying Connected in a Large, Diverse Orgainziation
Palm Springs: A PCSO Favorite
Trustee Report
PCSO at a Glance
PCSO Member News
AAOF Report
Special Section on CBCT
CBCT Imaging Protocols Within PCSO Residency Programs
Cone-Beam Computed Tomography in Orthodontics - Benefits of Comprehensive Visualization
Case Report Pre-Treatment
CBCT in Today's Orthodontic Practice
Case Report Post-Treatment
Differentiating Posterior Crossbites with CBCT Volumetric Images
Apps for the Orthodontist
Dr. Ib Leth Nielsen, San Francisco, CA
Dr. Robert J. Bendzak
Dr. Arthur A. Dugoni's 90th Birthday Makes for a Special Alumni Meeting in San Francisco
Preparing for the Unexpected: Your Emotional SOS Plan, Part II
Resident Spotlight
Hygiene: A New Battle for an Old War
Dr. Peter Picard, 1919-2013

Pacific Coast Society of Orthodontists Bulletin Summer 2015

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