3D Imaging Revolutionizes Orthodontics

By  //  February 21, 2013

Loading the player ...
Share on Facebook Share on Twitter Share on LinkedIn Share on Delicious Digg This Stumble This

DENTAL SPECIALISTS

ABOVE VIDEO: The Ouellettes have developed the concept of the “Polymorphic Cube” skeletal base or the anatomical foundation. The above video demonstrates how this information can be used to make diagnostic decisions and often discover patients predisposed to obstructive sleep apnea (OSA). 

Panoramic X-Rays Have Significant Limitations

Orthodontists are trained to diagnose, treatment plan and straighten crooked teeth.  Two-dimensional x-rays such as panoramic, cephalometric, occlusal and periapical x-rays are the current standard of care used by 95 percent of orthodontists worldwide.

A TRUE FAMILY PRACTICE, Dr. Paul Ouellette shares ownership with his two sons, Drs. Jason (far left) and Jonathan (far right) of DentalSpecialists.com and practices out of their multiple locations. Dr. Paul’s daughter, Danielle (second from left), is a pre-dental student. (Image for SpaceCoastDaily.com)

Using current dental imaging technology to diagnose orthodontic problems may not reveal the complete picture.  The majority of orthodontic cases are diagnosed and treatment planned using 2D x-rays.  Cone Beam Computed Tomography (3D CBCT) imaging recently introduced to orthodontics is changing the way we diagnose and safely move teeth.

In 1960-1970s Larry Andrews, DDS  introduced the concept of  the Six Keys to Optimal Occlusion (bite relationship) and the Andrews Straightwire Orthodontic Appliance (pre-adjusted braces).

Dr. Paul Ouellette talks about the advantages of modern technology on orthodontics. (Video image for SpaceCoastDaily.com)

Prior to Dr. Andrew’s significant contribution to orthodontics, doctors had to make multiple adjustments to archwires to effectively move teeth into corrected positions.  In other words, the archwire was the key to moving teeth.

The Andrews Straightwire protocol transferred the force systems into the brackets (braces).

Precise angulations, in-out adjustments, tipping, torque and other force components were engineered into the braces.  Therefore, the orthodontist could use a straight pre-formed wire to efficiently move teeth.  Andrew’s concept was a paradigm shift in orthodontics that dramatically shortened treatment times and improved the overall quality of cases.

The majority of orthodontists today use a Straightwire protocol or variations of Andrews orthodontic appliance.

 3D CBCT IMAGING GIVES COMPLETE PICTURE

The introduction of 3D CBCT imaging has now given us a more complete picture of how effective and safe orthodontic treatments can be using Andrew’s concepts.

The panoramic image (Panorex) is used by most orthodontists to evaluate root angulations, crown positions and to estimate the amount of bone support around each tooth.

3D CBCT images of teeth are near 100 percent accurate and have minimal distortions.  The “Anatomical Truth” as stated by Dr. Scott Ganz, Maxillofacial Prosthodontist and Implant Surgeon,  reveals what is really happening under the hood.

Determining the amount of bone around each tooth and identifying areas of thin bone or no bone is now possible before initiating orthodontic tooth movement.

SAFE TOOTH MOVEMENT

THE CONCEPTS in this article are featured in the Ouellette’s iPad book, 3D Dentists: The Future of Dentistry is Now!, which is available at the iTunes Bookstore.

Impacted teeth can be safely retrieved if the doctor is able to determine the exact position of teeth prior to administering orthodontic forces.  The picture below illustrates a significant complication of applying orthodontic forces to two maxillary impacted canines (upper eye-teeth).  Sadly, the patient lost six front teeth because the treating doctor used 2D images to plan the movement of the impacted teeth. 3D CBCT is the  evolving standard of care and is recommended for most impaction cases to avoid complications.

PANORAMIC X-RAY SHORTCOMINGS

Panoramic x-rays have significant limitations that must be considered when making diagnostic decisions.

Panoramic x-rays have significant limitations that must be considered when making diagnostic decisions. Panoramic images are generally magnified, exhibit distortions, double or triple images and have superimposed anatomical structures. Often these shortcomings can hide supernumerary (extra teeth) or missing teeth. On the panoramic image below you can see some of the problems described.

Panoramic images are generally magnified, exhibit distortions, double or triple images and have superimposed anatomical structures. Often these shortcomings can hide supernumerary (extra teeth) or missing teeth.  On the panoramic image below you can see some of the problems described.

3D Imaging makes it possible to quantify or discover anatomical asymmetries present in the majority of orthodontic patients prior to initiating treatment. Anatomical variation in the human head and neck is the norm, not the exception!

The Ouellettes have developed the concept of the “Polymorphic Cube” skeletal base or the anatomical foundation. The above video demonstrates how this information can be used to make diagnostic decisions and often discover patients predisposed to obstructive sleep apnea (OSA).

The airway is a significant area to be evaluated for the most comprehensive orthodontic diagnosis according to Doctor Juan Carlos Quintero of Miami, Florida.  The etiology (cause) of malocclusion,  planning for orthodontic relapse and predicting future airway issues can now be quantified with 3D imaging.

For more information call 321-779-0000 or log on to DentalSpecialist.com

ABOUT THE AUTHOR

Paul L. Ouellette, DDS, MS, ABO, is a board certified orthodontist who has practiced for more than 35 years. He received his college education and Bachelor of Science degree at Texas A&M University. He studied dentistry at Loyola University in Chicago, Illinois, where he earned his Doctorate of Dental Surgery, Certificate of Orthodontic Specialty, and Masters Degree in Oral Biology. Dr. Ouellette has three Dental Specialist office locations in Brevard County, Florida, and can be reached at 321-779-0000, or Dental Specialists.com.


Click here to contribute your news or announcements Free