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Orthodontic treatment planning without radiation exposure

A study has demonstrated the feasibility of orthodontic treatment planning without radiation exposure using MRI. (Photograph: Suttha Burawonk/Shutterstock)
Dental Tribune International

Dental Tribune International

Mon. 7. August 2017

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HEIDELBERG, Germany: When a patient requires orthodontic treatment, it is common practice to capture the dental malposition with a radiograph. Scientists from the Heidelberg University Hospital have now published a study in which an alternative treatment plan without radiation exposure was investigated. The study showed that magnetic resonance imaging (MRI) technology can provide accurate images of craniofacial structures.

The researchers were able to prove that landmarks—important anatomical points in the upper and lower jaws—can be measured with MRI as accurately as in lateral cephalometric radiographs: “Compared with the radiographs, we had very small differences, within the usual acceptable standard deviations. However, the great advantage of MRI is that it does not require any radiation exposure. Even though the radiation dose is low in dental examinations, it is preferable to avoid such exposure in children and adolescents,” said study lead Prof. Martin Bendszus, who now intends applying the technique on a larger scale. MRI technology could also be applied when 3-D imaging is required for specific orthodontic cases, for example in patients with severe malocclusion.

In the study, 20 participants between the ages of 8 and 26 were examined and received an MRI scan and lateral cephalometric radiographs. Two experts then independently identified 18 important landmarks in the jaws, based on which a special computer program calculated 14 angles and ten distances important for orthodontic treatment planning. A comparison of the data showed a deviation of a maximum of 3° for the angles and a maximum of 3 mm for the distances between the radiographs and the MRI images. According to the experts, these differences are within the tolerance range of imaging methods. Furthermore, especially for young patients, the short recording time of under 10 minutes is an advantage, they said, and the administration of a contrast medium is not required.

The researchers see great potential for the new method. “We can improve diagnostics because, in the future, we will also be able to offer clinical trials using 3-D analysis, which is even more accurate,” said Bendszus. He went on to explain that not only is dental MRI suitable for children, but it can also provide essential additional information in adult dentistry. Particularly for common dental diseases, such as periodontitis, MRI technology can be effective for early diagnosis based on soft-tissue changes. This is in contrast to a radiograph, which only shows changes in the bone structure.

The study, titled “Lateral cephalometric analysis for treatment planning in orthodontics based on MRI compared with radiographs: A feasibility study in children and adolescents,” was published online on 23 March in the PLOS ONE journal.

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