The role of X-rays and digital copies in orthodontic treatment planning
Why do we need X-rays and scans to plan orthodontic treatment?
X-rays and scans are essential for making an accurate orthodontic diagnosis and selecting an appropriate treatment plan.
A panoramic X-ray, or OPTG, allows for an assessment of the overall health and integrity of the teeth, roots, and jawbones, and also provides insight into the shape of the temporomandibular joints (TMJ) (image). By examining the shape and orientation of the roots, we can make safer and more appropriate decisions when planning treatment. A panoramic X-ray can confirm the presence and location of unerupted teeth and detect changes or damage that do not yet cause symptoms, allowing us to take necessary measures in a timely manner. In addition, a panoramic X-ray can be used to make a preliminary assessment of the maxillary sinuses (image) and detect, for example, mucosal thickening or other tissue growth.
In children, a panoramic X-ray helps determine the number and presence of erupting teeth, track the order of eruption, and assess the available space for tooth eruption.
A cephalometric X-ray, also known as a lateral cephalogram, allows for the measurement of tooth inclination and position in relation to the skull. It is used to assess the size of the jaws, their relationship to one another, and their relationship to other structures of the head, in order to identify potential malocclusions (i.e., bite type). The image also provides information on the shape of the lower jaw (image), facial length, growth direction, and tooth inclinations. This helps in making an accurate diagnosis and selecting the best treatment option.
In addition, a cephalometric X-ray allows for an assessment of the size of the nasopharyngeal airway, which may be associated with breathing difficulties and certain dental challenges.
In children, the stage of growth can be assessed by examining changes in the shape of the jawbones during development (figure). This helps determine whether the patient is approaching a growth spurt—allowing treatment to be timed appropriately—or whether growth has already ceased, in which case treatment options are adjusted accordingly.
Scanning is a modern alternative to traditional plaster models. In the past, models were used to record the bite and measure the space along the dental arch. Today, digital scans are an excellent tool that, in addition to the aforementioned assessments, also enable simulations that illustrate the final outcome of treatment.
These examinations, together with photographs of the patient’s face and inside the mouth, make it possible to document the initial condition and make an accurate diagnosis. It is important to remember that orthodontic treatment does not simply mean straightening the teeth, but rather aligning them in harmony with the surrounding structures to achieve the best possible functional and aesthetic outcome.
