Cone beam computed tomography--current understanding and evidence for its orthodontic applications?

Cone beam computed tomography (CBCT) is a fast developing technology which provides relatively low-dose, high spatial resolution imaging of the craniofacial complex in three dimensions (3D). During the past decade, the number of CBCT-related publications in the literature has increased significantly, but the crucial question is whether this technology leads to improved outcomes. In this paper, the literature is reviewed and the main applications of CBCT in orthodontics are highlighted, as well as the current evidence and understanding in each area. It is clear that at the present time, despite the popularity of CBCT, there is no clear evidence that the information obtained from these images substantially enhances clinical treatment decisions. Future research on CBCT should focus on interpretation of the images obtained. Visualizing the dentofacial skeleton in ever greater detail may be seductive, but without understanding the implications of findings such as 'minor' external root resorption or having the technical ability to provide treatment at a microscopic level may mean that these images do not have any meaningful impact on clinical practice.