Cone Beam

The Use of Cone Beam Computed
Tomography for the Evaluation of Pathology,
Developmental Anomalies and Traumatic
Injuries Relevant to Orthodontics
Byung-Cheol Kang, Suk-Ja Yoon, Jae-Seo Lee, Wisam Al-Rawi, and
J. Martin Palomo
The objective of this work is to illustrate pathologic conditions relevant to
orthodontists who use dental cone beam computed tomography (CBCT) images. A total of1703 cases from 2300 CBCT images taken from June 2006 to
May 2009 were reviewed, and interesting cases that might be related to orthodontic treatment or evaluation were selected. A total of 427 cases were
selected. The conditions included supernumerary tooth (84 cases), missing
tooth (29 cases), impacted tooth (35 cases of impacted canine), external root
resorption (7 cases), root fracture (18cases), simple bone cyst (13 cases),
dentigerous cyst (58 cases), abscess (33 cases), osteomyelitis (51 cases), odontoma (8 cases), mucus retention cyst (20 cases), temporomandibular joints (70
cases), and cleft palate (11 cases), including surgical correction with/without
bone grafting, cortical bone width (buccal and lingual cortical bone around the
roots), impacted tooth andtooth-button-traction, surgical positioning of orthodontic mini-implants for anchorage and others. The conditions presented here
are common on 2-dimensional radiographic images but may not look familiar
with computed tomography images. The CBCT images with 3-dimensional
capabilities provided fine details of the dental conditions and allowed fine bony
changes to be detected from different viewing angles. (SeminOrthod 2011;17:
20-33.) © 2011 Elsevier Inc. All rights reserved.

he websites of companies that manufacture
dental cone beam computed tomography
(CBCT) machines provide many examples illustrating the value of CBCT in evaluating implant
planning and dental conditions. Many lesions
that occur in the jaw can be diagnosed with
2-dimensional (2D) intraoral radiographs and
extraoralradiographs, including panoramic radiographs. Intraoral radiographs offer a highly
detailed view of the teeth and bone in the area
imaged. Panoramic radiographs often are used
initially for evaluation and are useful for patients
who do not tolerate intraoral procedures well.
However, the images may not have high resolution and sharp details available on intraoral images.1
At the present time, it ispossible to acquire
3D images of the oral and maxillofacial struc-

T

Professor and Chairman, Department of Oral and Maxillofacial
Radiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea; Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry,
Dental Science Research Institute, Chonnam NationalUniversity,
Gwangju, Korea; Clinical Assistant Professor, Department of Oral and
Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju, Korea; Assistant Professor, Department of Oral Diagnosis and Radiology, Case Western Reserve University, Cleveland,
OH; Associate Professor, Department of Orthodontics and Imaging
Center Director, Case Western Reserve University, Cleveland,OH.
Address correspondence to Dr Byung-Cheol Kang, Professor,
Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, 333 Yongbongdong, Bukgu, Gwangju 500-757, South Korea. E-mail: bckang@chonnam.ac.kr
© 2011 Elsevier Inc. All rights reserved.
1073-8746/11/1701-0$30.00/0
doi:10.1053/j.sodo.2010.08.005

20Seminars in Orthodontics, Vol 17, No 1 (March), 2011: pp 20-33

CBCT for Pathology, Developmental Anomalies, and Traumatic Injuries

tures by the use of CBCT with a high resolution
of 0.001 mm3 voxels, and these 3D images could
provide a better understanding of many anatomical structures, as well as pathologic conditions,
developmental anomalies, and traumatic injuries.
The Department of Oral...