Craniofacial imaging in orthodontics: Historical perspective, current status, and future developments

Rapid and substantial advances in imaging methods and technology have not a lways been expediently or adequately communicated to the practicing orthodo ntist. In this review we highlight contemporary imaging techniques and inno vations in imaging that, in the future, are likely to greatly improve the d epiction of craniofacial structures for use in diagnosis and treatment plan ning. In order to provide an appropriate background for this topic, we firs t discuss the evolution of craniofacial imaging in orthodontics and review the limitations of current methods, including the two-dimensional represent ation of three-dimensional anatomy, depiction as a patchwork of site-specif ic images, associated geometric errors, and images that have a limited poin t of view and are static in space and time. Three-dimensional computed tomo graphy can be considered a partial solution to these limitations, but imagi ng costs, radiation exposure, and lack of soft tissue representation may ma ke it unacceptable for routine orthodontics, A more complete solution might be achieved through digital processing of contemporary imaging technologie s that would extend their capabilities, overcome many of their limitations, and result in an increase in the amount of relevant information obtained. Digital processes are currently being developed that create accurate multid imensional models that integrate form and function. These models will be in teractive, linked to knowledge databases, and will provide the clinician wi th answers to pertinent questions. These advances in imaging are likely to enhance the accuracy and reliability of orthodontic diagnosis and treatment planning, and will be of importance in both clinical practice and research .