Cone Beam Computed Tomography in Orthodontics: Indications, Insights, and Innovations Cone Beam Computed Tomography in Orthodontics: Indications, Insights, and Innovations Sunil D. Kapila, BDS, MS, PhD Robert W. Browne Endowed Professor and Chair Department of Orthodontics and Pediatric Dentistry The University of Michigan School of Dentistry Ann Arbor, Michigan This edition first published 2014 © 2014 by John Wiley & Sons, Inc. Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing. Editorial offices: 2121 State Avenue, Ames, Iowa 50014-8300, USA The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 9600 Garsington Road, Oxford, OX4 2DQ, UK For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell. 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Limit of Liability/Disclaimer of Warranty: While the publisher and author(s) have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom. If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Cone beam computed tomography in orthodontics : indications, insights, and innovations / [edited by] Sunil Kapila. p. ; cm. Includes bibliographical references and index. ISBN 978-1-118-44848-9 (hardback) I. Kapila, Sunil (Sunil D.), 1958– , editor. [DNLM: 1. Cone-Beam Computed Tomography–methods. 2. Orthodontics–methods. 3. Malocclusion– radiography. 4. Radiography, Dental–methods. WU 400] RK523 617.6'43075722–dc23 2014032720 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover images supplied by Sebastian Baumgaertel, Sunil D. Kapila, Birte Melsen, and Michel Dalstra Cover design by Andy Meaden Set in 9.5/11.5 pt PalatinoLTStd-Roman by Toppan Best-set Premedia Limited 1 2014 To my wife, Yvonne, and our children Anjuli, Sahil, and Simran for their unconditional love and support. To my father, Dharam Inder, and late mother, Ved Kumari, for their nurturing guidance and numerous sacrifices. Contents List of Contributors ix Part 2 Protocols and Principles for Preface xiii Cone Beam Computed Tomography Acknowledgments xv Imaging in Orthodontics 113 6 Development of Evidence-Based Part 1 Technology Assessment Selection Criteria for Cone Beam and Enhancements 3 Computed Tomography in Orthodontics 115 1 Contemporary Concepts of Cone Beam William C. Scarfe, Kirt E. Simmons, and Computed Tomography in Orthodontics 5 Carla A. Evans Sunil D. Kapila 7 To Scan or Not to Scan: Medico-Legal 2 Functional and Technical Characteristics Implications 127 of Different Cone Beam Computed Bernard Friedland Tomography Units 43 Om P. Kharbanda, Neeraj Wadhawan, 8 Protocols for the Use of Cone Beam Rajiv Balachandran, Devasenathipathy Computed Tomography in Kandasamy, and Sunil D. Kapila Orthodontic Practice 139 Aaron D. Molen 3 Cone Beam Computed Tomography in Orthodontics: Perspectives on Radiation Risk 67 Sharon L. Brooks and John B. Ludlow Part 3 Diagnosis and Treatment Planning 165 4 Rational Basis for Transitioning from 2D to 3D Radiographic Imaging in 9 How to Interpret Cone Beam Computed Orthodontic Practice and Research 81 Tomography Scans 167 Birte Melsen and Michel Dalstra Christos Angelopoulos 5 The Future of Cone Beam Computed 10 Detection of Incidental Findings in Cone Tomography and 3D Imaging in Beam Computed Tomography Imaging Orthodontics 103 and Their Clinical Implications 185 Michael W. Vannier and Bin Jiang Erika Benavides and Paul C. Edwards vii viii  Contents 11 3D Orthodontic Diagnosis and Treatment 18 Planning and Placing Temporary Planning 221 Anchorage Devices with the Aid of Juan Martin Palomo, Manish Valiathan, Cone Beam Computed Tomography and Mark G. Hans Imaging 411 Sebastian Baumgaertel 12 Application of 3D TMJ Imaging to TMJDs, TMJ Functional Analyses, and 19 3D Planning and Treatment Outcomes Orthodontic Treatment Outcomes 247 of Bone Anchored Maxillary Anna-Kari Hajati, Lucia H.S. Cevidanes, Protraction 427 Laura Iwasaki, Jeffrey C. Nickel, and Tung Nguyen Sunil D. Kapila 20 Applications of Cone Beam Computed 13 Characterization of the Upper Airway Tomography to Orthognathic Surgery Morphology and Its Changes in the Treatment Planning 437 Apneic Patient Using Cone Beam Sean P. Edwards and R. Scott Conley Computed Tomography 273 R. Scott Conley, Paolo M. Cattaneo, and 21 3D Diagnosis and Management of Bruce S. Haskell Facial Asymmetries 453 Abeer AlHadidi, Lucia H.S. Cevidanes, 14 Alveolar Boundary Conditions and Beatriz Paniagua in Orthodontic Diagnosis and Treatment Planning 293 22 3D Assessment of Orthognathic Sunil D. Kapila and Jeanne M. Nervina Surgical Outcomes 463 Yoon-Ji R. Kim, Yang-Ho Park, Leonardo Koerich de Paula, and Part 4 Clinical Applications and R. Scott Conley Treatment Outcomes 317 23 3D Imaging in Diagnosis and Treatment 15 Assessment of Root Position and Planning of Craniofacial Anomalies 485 Morphology by Cone Beam Snehlata Oberoi, Jeanne M. Nervina, and Computed Tomography 319 Karin Vargervik Jeanne M. Nervina and Sunil D. Kapila 16 3D Image-Aided Diagnosis and Index 509 Treatment of Impacted and Transposed Teeth 349 Sunil D. Kapila and Jeanne M. Nervina 17 Assessment of Maxillary Transverse Deficiency and Treatment Outcomes by Cone Beam Computed Tomography 383 Jeanne M. Nervina, Sunil D. Kapila, and Carlos Flores-Mir