%0 Journal Article
%T Integration of Digital Dental Casts in Cone-Beam Computed Tomography Scans
%A Frits A. Rangel
%A Thomas J. J. Maal
%A Stefaan J. Berg¨¦
%A Anne Marie Kuijpers-Jagtman
%J ISRN Dentistry
%D 2012
%R 10.5402/2012/949086
%X Cone-beam computed tomography (CBCT) is widely used in maxillofacial surgery. The CBCT image of the dental arches, however, is of insufficient quality to use in digital planning of orthognathic surgery. Several authors have described methods to integrate digital dental casts into CBCT scans, but all reported methods have drawbacks. The aim of this feasibility study is to present a new simplified method to integrate digital dental casts into CBCT scans. In a patient scheduled for orthognathic surgery, titanium markers were glued to the gingiva. Next, a CBCT scan and dental impressions were made. During the impression-taking procedure, the titanium markers were transferred to the impression. The impressions were scanned, and all CBCT datasets were exported in DICOM format. The two datasets were matched, and the dentition derived from the scanned impressions was transferred to the CBCT of the patient. After matching the two datasets, the average distance between the corresponding markers was 0.1£¿mm. This novel method allows for the integration of digital dental casts into CBCT scans, overcoming problems such as unwanted extra radiation exposure, distortion of soft tissues due to the use of bite jigs, and time-consuming digital data handling. 1. Introduction With the introduction of cone-beam computed tomography (CBCT), it became possible to obtain an accurate three-dimensional (3D) representation of the patient¡¯s head with much lower radiation exposure than multislice computed tomography (MSCT) and a much higher information content compared to two-dimensional (2D) radiographs. This has proven to be a useful tool in diagnosis and treatment planning for certain problems in the maxillofacial region [1, 2]. When these 3D diagnostic methods are combined with 3D planning software, orthognathic surgery can be planned digitally and then transferred to the patient, which may reduce errors in terms of materials, construction of appliances, and hand skills [3]. Using software programs, 3D reconstructions can be modified, and simulation of the proposed surgery can be performed. Unfortunately, 3D virtual planning of orthognathic surgery still suffers from the disadvantages of CBCT imaging. For orthognathic surgery, a good representation of the dental surfaces and the occlusion is needed to properly position the dental arches. However, CBCT provides insufficient visualisation of the dental arches, since the teeth are not accurately rendered, and CBCT scans are subject to scattering from artefacts at the occlusal level [4¨C7]. Digital dental casts provide an accurate and
%U http://www.hindawi.com/journals/isrn.dentistry/2012/949086/