Cone-beam computed tomography prescription by Brazilian orthodontists

Abstract

Objective: To investigate the factors that influence Cone-beam computed tomography (CBCT) imaging prescription in Brazilian orthodontics practice. Methods: This cross-sectional study was performed in 2020 using an online survey sent to all Brazilian orthodontists registered at the Federal Council of Dentistry. The variables were the orthodontists’ demographic features and the CBCT prescription in clinical practice. A descriptive and comparative analysis was implemented using frequencies and the chi-square test, respectively. Results: The sample consisted of 939 respondents. CBCT prescription and the use of guidelines for imaging in orthodontics were confirmed by 81.9% and 52.6% of the sample, respectively. Training for CBCT was reported by 37.0%, mainly during specialization programs in orthodontics (50.0%), about one to five years ago (64.7%), with a duration of 4 to 8 hours (53.4%). The CBCT prescription was indicated predominantly for specific cases (71.0%), and was generally related to impacted teeth (74.7%), orthognathic surgical patients (46.2%), and root resorption (41.9%). The results indicated differences in CBCT prescription between the Brazilian macro-regions, regarding the criteria for prescription, use of guidelines, reasons for not recommending the exam, diagnostic purposes, voxel size, and training for the use of CBCT (p<0.05). Conclusion: The prescription of CBCT was adequate by most Brazilian orthodontists for cases involving impacted teeth, surgical interventions, and root resorption. However, adherence to imaging prescription guidelines was observed in less than 50% of the sample. There is a deficiency in understanding technical parameters and a lack of specific training on CBCT. Disparities were evident among the Brazilian macro-regions, particularly concerning CBCT costs and other variables analyzed.