3D – The Step To Smile Perfection - Dr. Asif Chatoo, London Lingual

3D – The Step To Smile Perfection

Today patients expect the perfect smile from orthodontics – and such perfection demands extremely detailed measurements being taken as no two patients are alike.

To achieve the results that patients are after requires a superb custom fit of the appliances being used, whether the lingual braces are being fitted for cosmetic and/or health reasons. 3D computed tomography (CT) scanning is the very latest technology available to dental surgeons and a technology that I am delighted to see in my sphere of work. It enables the dental surgeon to vizualize the internal features that are being diagnosed externally.

The i-CAT Cone Beam 3D Imaging System, which I use as part of my clinical diagnosis, provides three-dimensional views to be taken of the patient’s skull and teeth. The scan gives me a very clear view and measures to 0.01 cm accuracy in any area of the head and neck. It also may provide important information about bone density. This may be useful for assessing how easily teeth may move or the suitability of the patient for treatment with implants. Patients are often surprised at how fast images are taken and proccessed– the average speed is around 20 seconds. The Cone Beam scanners have the advantage of using much lower levels of radiation than traditional CT scanners. This is very reassuring for all my patients.

3D scanning is invaluable in:
• Planing treatment and surgery
• Assesing risk
• Looking at the position and orientation of critical structures such as nerves, teeth roots, the sinus and nose.

Clinical assessment

Orthodontics places emphasis on modifying abnormal craniofacial growth patterns as well as the correction of dental malrelationships. Good results are dependent on a good diagnosis that involves reliable images of the cranio facial complex. Unlike traditional x-rays, CT scans can discriminate between many types of tissue, including teeth, bone, nerves and soft tissue.

The 3D scan is also an important tool in my clinical assessment of possible pathology that may have an impact on treatment, such as looking at the quality of previous root canal treatment in patients, to assess risk factors involved in moving these teeth. It is also invaluable in assessing root resorption. By looking at a 3D scan I can more accurately measure the shape, length, size and form of roots, so that I can identify patients who may be more susceptible to root resportion.

3D imaging also has the added advantaged in that it can often detect and help to evaluate problems in patients before they become more serious such as bone lesions like cysts and tumours.

As well as being an aid to creating perfectly fitting lingual braces, CT scanning can also help orthodontic surgeons in a number of other areas. Impaction of unerupted teeth can be a common orthodontic problem. The main problem is identifying the precise location of the tooth and possible structures that may complicate the exposure of the tooth. 3D scans provide an excellent way to accurately locate the tooth and identify structures such as roots nerves and blood veesels.3D CT scanning is a large investment for clinics – but is undoubtedly the way forward in the diagnosis and treatment planning for orthodontic patents.

Dr. Asif Chatoo

Dr Asif Chatoo, BSc., BDS, FDS RCS (Eng), MSc., MOrth RCS (Eng)
is a specialist in Orthodontics. www.londonlingualbraces.com