Comparison between 2D and 3D Cephalometric Analyses

The cephalogram has been in use by orthodontists as a standard method for assessing the dental, soft tissue and skeletal relationships in patients for some time. 2D or direct cephalometric x-rayanalysis has been used successfully now for over 70 years in orthodontic practices. Currently, its status amongst orthodontists is stable although dental clinics start to use 3D cephalometric analysis as well.

Despite the fact the use of 3D X-rays are becoming more a part of dental practices, this doesn’t mean there is no meaningful role for 2D imaging still has a rightful place, that doesn’t suffer as much from the effects of radiation exposure.

Cephalometric radiography has developed as a key orthodontic diagnostic tool and before craniomaxillofacial surgery is considered. Typically, cephalometric factors are measured by using the two-dimensional cephalometric analysis on either lateral or frontal analysis. More recent studies have shown that 3D imaging presents greater reliability.

This 2D approachprovides a 2D view of what is unarguably a 3D object. The 3D technology is increasingly being accessed and assessed for optimal orthodontic treatment and results, but cephalometric x-raysare still the most common x-ray cephalometric analyses which in use by orthodontists. The 2D method does provide sufficient information which enables the orthodontist to make good judgments regarding the most suitable orthodontic treatment. In the not too distant future 3D cephalometric analysis are likely to be introduced more into orthodontic practices.

How a cephalometric scan is used

The process when doing a 3D cephalometric scan is a bit different when doing a 2D cephalometric scan. The 2D ceph is taken on the side of the patient’s head, while a CBCT scan takes place when the C-arm or gantry rotates 360 degrees around the head capturing multiple images in the process from a number of different angles which are then reconstructed to form a single 3D image.

After the ceph analysis is ready, the orthodontist can then make good decisions about treatment options for the patient. The 3D technique enables the orthodontist to calculate how certain orthodontic treatments will affect the patient’s jaw and the bone surrounding it. It also gives an idea of the growth tendency of the teeth and jaw. This information, if required, may also be used to decide on a course of treatment.

Similarities between 2D and 3D cephalometric x-rays

Cone-beam computed tomography (CBCT) enables the orthodontist to get craniofacial measurements in 3D with good geometric accuracy. CBCT is also starting to target 3D cephalometric analysis. The one problem detected is the amount of radiation exposure that CBCT causes which is relatively higher when compared to more conventional radiographs. This is no doubt one of the constraints that will need to be addressed so many orthodontists restrict its use to high priority patients who need a detailed diagnosis.

One of the attributes of this technology for the orthodontist is the increase in diagnostic accuracy compared to 2D x-rays, particularly when identifying orthodontic conditions such as overlaid teeth, hidden nerve channels, impacted teeth, airways analyses and concealed roots or anomalies in the temporomandibular joint. 3D cephalometric x-rays are no doubt a useful advancement in technology but there are some features they share with 2D. The 3D cephalometric x-rays has higher exposure to radiation, but their images come in high resolution so they are clear to view.

When trying to locate an incisor tooth on a cephalogram when a patient is suffering from crowding of the anterior teeth these featurescan be located quite easily using the 3D method. It is also able to reduce the mistakes of identification and projection that lead to errors in cephalometric measurement.

Immediate cephalometric analyses provided by CephX

At CephX, we help orthodontic practitioners around the globe to save precious time and to receive an immediate and high-quality cephalometric analysis they now expect. Currently our service available on the basis of 2D x-rays only. We are determined to keep up with cephalometric analysis trends so we can meet the needs of our orthodontists who are starting to use 3D scanners more and more.

Once this feature will beready, you can expect the same cutting-edge service as you have been receiving from us up to now.

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