Dental Tribune Middle East & Africa Edition

al of the proper teeth (Fig. 12). Knowing the exact position of many of these teeth is a benefit to both the doctor and patient. It will lead to the most precise surgical path and the least invasive procedure. Periodontics The explanation of periodontal problems are often misunderstood by the patient. As doctors we talk about pockets, point to X-rays and propose treatment only to have patients refuse treatment because they do not understand what we are clinically de- scribing. Using the 3-D portion of the CBCT scan can improve the understand- ing and acceptance of treatment plans. The images are a picture of the problem that is owned by that patient and much easier to understand by the layperson. Il- lustrating periodontal defects and pockets allows the patient to better participate in the process (Fig. 13). The MPRs and the 3-D projections aid in surgical planning for periodontists, allow- ing for accurate measurements and bone analysis prior to osseous surgery that doctors cannot get using the periapicals or panoramics. Studies have shown that CBCT images are more accurate than pan- oramic radiographs. For the periodontist placing implants, the ability to measure bone density and avoid important anato- my is important.4,5 Orthodontics Orthodontists are beginning to adopt large field-of-view CBCT. Recent studies show that linear measurements of bony struc- tures are more accurate using CBCT and have less distortion than currently used methods of measurement: lateral cephalo- metric, posteroanterior (PA) and submento- vertex (SMVT).5 Accurate measurements of tooth volume and tooth position can aid in accelerated treatment times and more pre- cise treatment. Along with tooth position, density of bone and size of arches, the ortho- dontist also has an accurate evaluation of the temporomandibular joint and position of the condyles. Impacted teeth are easily iden- tified and position either buccal or lingual can be confirmed prior to movement or re- moval. Both MPRs and 3-D projections give the clinician a complete picture of the prob- lems and the treatment course. With a single CBCT scan, orthodontists can produce all of the information they need: panoramic, cephalametric, PA, SMVT, tooth size and volume, crowding evalua- tion in any plane, TMJ evaluation and air- way analysis, all with both soft-tissue and skeletal information.5,7 Dan McEowen, DDS, is a 1982 graduate of Loma Linda School of Dentist- ry and has been in pri- vate practice for 26 years. He is a founding member of the World Clinical La- ser Institute, achieving a mastership level of proficiency. He has been active in FDA approval of oral surgery tech- niques using Erbium lasers. McEowen has lectured and trained internationally in tech- niques using lasers in general and specialty dental fields. He a member of the ICOI and is active in implantology. McEowen has been involved in cone-beam technology for more than five years and owns 3D Imaging Cen- ter in Maryland. Contact Information Fig. 12 The 3-D rendering showing supernumary teeth and positions. Fig. 13 The 3-D Rendering with peri- odontal defects and calculus bridge. Fig. 12 Fig. 13 DUBAI, UAE NEW YORK CITY, USA APRIL 11-12-13, 2013 OCTOBER 14-25, 2013 Centre for Advanced Professional Practices Centre for Advanced Professional Practices (CAPP) is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.2014 to be announced MIDDLE EAST PROGRAM CAPP designates this activity for 201 CME Hours presented by CAPP FZ LLC | T: +971 4 3616174 | F: +971 4 3686883 | E: events@cappmea.com | www.cappmea.com/nyu disposal. As with any type of invasive di- agnostic tool, clinicians should weigh the risk to benefit in using CBCT scans. Judicious use of CBCT and knowledge of patient’s lifetime doses should always be a consideration as well as the availabili- ty of other diagnostic tests appropriate for the problems of the patient. When adopt- ing new technology, training is paramount. Along with training comes the responsibil- ity of the doctor to read and diagnose in- formation from CBCT scans. Do not avoid CBCT from lack of knowl- edge; instead, take this opportunity to be- come a better diagnostician and radiolo- gist. As you review radiology and pathol- ogy, your use of CBCT will aid in making the most accurate diagnosis and the most complete treatment plans. Editorial Note: A complete list of references is avail- able from the publisher. Conclusion We treat our patients in 3-D, and now, with cone-beam computed tomography, we are changing the way we diagnose from 2-D to 3-D. The addition of this technology will increase your diagnostic skills with bet- ter and more complete information at your Fig. 6 Periapical showing minimal pathology with no radiolucency. Fig. 7 Coronal MPR showing a short fill on the mesial lingual and radiolucency. Fig. 8 Saggital MPR showing unfilled canal and radiolucency. Fig. 9 Periapical showing a normal fill with a radiolucency. Fig. 10 Coronal MPR showing the superimposed lingual root unfilled. Fig. 11 Coronal MPR showing nerve between roots of the third molar. Fig. 9 Fig. 7 Fig. 10 Fig. 8 Fig. 11 Fig. 6 11MEDIA CMEDental tribune Middle East & Africa Edition | March-April 2013