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    The future will be in 3D

    How CBCT scanners like the Planmeca ProMax 3D Mid are changing the way orthodontists practice.


    We can now extrapolate a coronal view that allows us to visualize many anatomical structures to formulate a diagnoses and treatment plan. The coronal view with a slice taken through the lingual roots of the maxillary first molars can be used to accurately determine the width of the maxilla and the inclinations of the maxillary molars (Fig. 5). We can then determine the mechanics needed for our patients in this dimension. The mechanics utilized on the patient in Figure 5 were expanded with skeletal fixation of the expander. No bands were attached to the molars.

    Therefore, true horizontal expansion was achieved (Figs. 6a, 6b, 6c). These images were taken at the ULD settings on a Planmeca ProMax 3D Mid. Before placing stainless steel wires, many orthodontists will take a progress pan. to evaluate the roots of the teeth as far as proper bracket placements. This is an additional 35 microsieverts when using a traditional 2D panoramic machine. The ULD setting on the Planmeca Pro-Max 3D Mid machine with a limited field of view that only images the teeth is an effective dose of around 9 microsieverts.

    RadiographFig. 5True horizontal expansion achievedFig. 6a






    RadiographFig. 6b3DFig. 6c






    As far as final records: a full scan with the Planmeca ProMax 3D Mid machine is again 13 to 14 microsieverts. A ceph. and 2D pan can then be extrapolated from this set of DICOM files. The initial and final tracings can now be superimposed to evaluate the treatment. Yes, these are 2D images attained from a 3D scan. If a 3D image is superimposed on a traditional flat image, the super impositions will not be accurate, just as the arches of a human are not flat. However, the distortions are minimal. Comparisons are what need to be imaged. If we see more, know more and do more, our patients will ultimately benefit.


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