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. 2022 Feb;26(2):1625-1636.
doi: 10.1007/s00784-021-04135-9. Epub 2021 Aug 23.

Orthodontists' criteria for prescribing cone-beam computed tomography-a multi-country survey

Grasielle Manoel Caiado  1 , Karine Evangelista  1 , Maria do Carmo Matias Freire  1 , Fabiana Tolentino Almeida  2 , Camila Pacheco-Pereira  2 , Carlos Flores-Mir  2 , Lucia Helena Soares Cevidanes  3 , Antonio Carlos de Oliveira Ruelas  4 , Karla de Faria Vasconcelos  5 , Flavia Preda  5 , Guy Willems  5 , Reinhilde Jacobs  5 , José Valladares-Neto  1 , Maria Alves Garcia Silva  6
Affiliations

Orthodontists' criteria for prescribing cone-beam computed tomography-a multi-country survey

Grasielle Manoel Caiado et al. Clin Oral Investig. 2022 Feb.

Abstract

Objectives: This study aimed to describe and compare CBCT imaging prescription in clinical practice among orthodontists from five countries in Europe and America. Additionally, it investigated factors associated with the prescribing and the use of guidelines for CBCT imaging.

Materials and methods: A cross-sectional survey was carried out using an online questionnaire sent to all registered orthodontists in Belgium, Brazil, Canada, Romania, and the United States of America (USA). The data were analyzed by descriptive statistics, bivariate tests, and Poisson regression.

Results: The final sample consisted of 1284 participants. CBCT was prescribed by 84.4% of the participants for selected cases (84.9%), mainly for impacted teeth (92.4%), presurgical planning (54.1%), and root resorption (51.9%). High cost was most frequently the limiting factor for CBCT prescription (55.4%). Only 45.2% of those who were using CBCT imaging reported adhering to guidelines. CBCT imaging prescription was associated with the orthodontists' countries (p < .009, except for Belgium, p = .068), while the use of guidelines was associated with the respondents' country and additional training on CBCT imaging (p < .001).

Conclusions: Orthodontists refer patients for CBCT for selected indications (impacted teeth, root resorption, presurgical planning, dentofacial deformities, as suggested by the international guidelines, and also for upper airway and temporomandibular joint evaluation). Many do not adhere to specific guidelines. There are substantial variations between the countries about the orthodontists' referral for CBCT and guideline usage, irrespective of gender. CBCT prescription may be limited by financial barriers, adhering to specific guidelines and prior CBCT training.

Clinical relevance: CBCT prescription among orthodontists must be based on prescription criteria and current guidelines. It is advised to improve CBCT education and training to enhance CBCT selection, referral, analysis, and interpretation in orthodontic practice.

Keywords: CBCT; Cone-beam computed tomography; Diagnosis; Orthodontics; Survey.

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Conflict of interest statement

Conflict of interest The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the development of the questionnaire
Fig. 2
Fig. 2
Flowchart of number of participants in each study phase
Fig. 3
Fig. 3
Proportion of orthodontists, in each country, who refer the CBCT to an oral and maxillofacial radiologist
See this image and copyright information in PMC

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