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
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