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

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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.

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Author information

Authors and Affiliations

  1. Department of Stomatology & Division of Orthodontics, School of Dentistry, Federal University of Goiás, 1a Avenida, S/N, esq. praça universitária, setor Universitário, Goiânia, Goiás, 74605-220, Brazil

    Grasielle Manoel Caiado, Karine Evangelista, Maria do Carmo Matias Freire, José Valladares-Neto & Maria Alves Garcia Silva

  2. Division of Oral Pathology and Radiology & Division of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, 116 St. and 85 Ave., Edmonton, Canada

    Fabiana Tolentino Almeida, Camila Pacheco-Pereira & Carlos Flores-Mir

  3. Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, 500 S State St, Ann Arbor, MI, USA

    Lucia Helena Soares Cevidanes

  4. Department of Orthodontics, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, Rio de Janeiro, 373, Brazil

    Antonio Carlos de Oliveira Ruelas

  5. Department of Imaging and Pathology & Department of Oral Health Sciences-Orthodontics, Faculty of Medicine, Katholieke Universiteit Leuven, Oude Markt 13, Leuven, Belgium

    Karla de Faria Vasconcelos, Flavia Preda, Guy Willems & Reinhilde Jacobs

Authors
  1. Grasielle Manoel Caiado
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  2. Karine Evangelista
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  3. Maria do Carmo Matias Freire
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  4. Fabiana Tolentino Almeida
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  5. Camila Pacheco-Pereira
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  6. Carlos Flores-Mir
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  7. Lucia Helena Soares Cevidanes
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  8. Antonio Carlos de Oliveira Ruelas
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  9. Karla de Faria Vasconcelos
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  10. Flavia Preda
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  11. Guy Willems
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  12. Reinhilde Jacobs
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  13. José Valladares-Neto
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  14. Maria Alves Garcia Silva
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Contributions

Conceptualization: Maria Alves Garcia Silva and José Valladares-Neto; methodology: Maria Alves Garcia Silva, Fabiana Tolentino Almeida, Maria do Carmo Matias Freire; formal analysis and investigation: Grasielle Manoel Caiado, Karine Evangelista, Maria do Carmo Matias Freire, Camila Pachêco-Pereira, Karla de Faria Vasconcelos, Guy Willems; writing—original draft preparation: Grasielle Manoel Caiado; writing—review and editing: Maria Alves Garcia Silva, Maria do Carmo Matias Freire, Camila Pachêco-Pereira, Carlos Flores-Mir, Lucia Cevidanes, Reinhilde Jacobs, Flavia Preda, Karla de Faria Vasconcelos, Guy Willems; supervision: José-Valladares-Neto and Maria Alves Garcia Silva. All authors approved the final manuscript.

Corresponding author

Correspondence to Maria Alves Garcia Silva.

Ethics declarations

Ethics approval

The study was approved by the Ethics Committees of the Federal University of Goiás, Brazil (#15742619.7.0000.5083); University of Michigan, USA (#HUM00162784); KU Leuven, Belgium (#S63051); and the University of Alberta, Canada (#Pro00092421). All procedures performed in the study involving human participants followed the Ethics Committees’ ethical standards cited above. The study was also following the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Appendix 1 shows the English version of the questionnaire. (PDF 68 KB)

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Caiado, G.M., Evangelista, K., Freire, M.d.C.M. et al. Orthodontists’ criteria for prescribing cone-beam computed tomography—a multi-country survey. Clin Oral Invest 26, 1625–1636 (2022). https://doi.org/10.1007/s00784-021-04135-9

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  • DOI: https://doi.org/10.1007/s00784-021-04135-9

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