Comparison of the Effect of Using Panoramic and Cone-beam Computed Tomography on the Accuracy of Root Position in Indirect Digital Bracket Placement: A Retrospective Study

Objective: The purpose of this study was to compare the root position accuracy of the use of panoramic radiography and cone-beam computed tomography (CBCT) in the indirect digital bracket placement.

Methods: Two hundred and eighty-six maxillary and 300 mandibular teeth of 27 patients who have digital model, panoramic image and CBCT scan were included to the study. Indirect digital bonding was performed by using digital models and panoramic images in Group 1 and by superimposing the CBCT on the digital models with the OrthoAnalyzer™ 2020 (3Shape, Copenhagen, Denmark) software in Group 2. Angular measurements were calculated with 3-dimensional superimposition of the positions of the brackets placed with the Gom Inspect 2020 software. In the statistical analysis, One-way Analysis of Variance (ANOVA) and the Paired t test were used.

Results: Maxillary canines had the highest angular deviation at 5.56°± 4.01° in comparison with the maxillary teeth (P < .001). Mandibular canines and second premolars had the highest angular deviation in the comparison between mandibular teeth (P < .001). Considering the groups of ranges by clinical limits of the deviations, these differences were significant in the angular dimensions with 3.57° ± 2.59° (P < .001). The amount of deviation of all teeth was found 3.57° ± 2.59°in the study.

Conclusions: Using panoramic images or CBCT in the digital bonding had clinical significantly effects on the angular deviation of bracket position. These findings may be taken into consideration when implementing bracket placement in indirect digital bonding. Despite the successful results, indirect digital bonding should not be the single reason to take the CBCT from the patients.