Alternatives to Radiation Investigations in Orthodontics

There has been a massive paradigm shift in investigatory tools at present. A greater surge of interest in soft tissue analysis, real time imaging and functional recordings to enhance our understanding of the complexity of the biological system is underway; with high emphasis on non-invasiveness and cost effectiveness. Current studies are looking at the possibilities of using non-ionizing alternatives to derive the required parameters to diagnose, treatment plan and evaluate the orthodontic case. This is in stark contrast to some decades ago where static hard tissue investigations were considered gold standard. This chapter will explore the different investigations traditionally used for Orthodontic treatment planning and evaluation of treatment objectives. Since the introduction of lateral cephalometrics in 1931 by Broadbent and Hoffrath this 2 dimensional investigation has been considered the ultimate. However, it has several key limitations – radiation exposure particularly for growing children, 2 dimensional representation of a 3 dimensional living body with static image output. The need to provide a more holistic view to the case assessment with new investigatory tools like 3D imaging, ultrasonography, video recordings and EMG are perhaps the way for the future to assess growing living functioning body. At the time of writing there is a wide array of imaging technology with innovative developments occurring at a phenomenal pace. Nearly every time one searches the world wide web something new is presented. The new hype3D video softwares are considered to be the next big thing 1. The imaging industry finds wide application in defence, architecture, resource industries and general entertainment. In the medical field, it has immense application for diagnosis and potential to generate understanding not previously possible with 2D investigations. The classic examples are MRI and CT scans 2-6. In orthodontics, the focus is more based on the external features and soft tissues and 3D reproductions are invaluable not only for diagnosis in general medical scenarios, but more so for treatment evaluation and long-term growth changes. However, the majority of published work tends to come from Japan followed by European and USA researchers 7-9. In this chapter a brief historical background of the different imaging techniques namely Lateral cephalometrics, sEMG, Ultrasonography & 3D imaging as used in contemporary investigations along with important findings from recent studies from author’s research involving such technology are discussed.