RECENT ADVANCES IN ORTHODONTIC DIAGNOSTIC AIDS

RECENT ADVANCES IN
ORTHODONTIC
DIAGNOSTIC AIDS
Presented by
Dr. SHEHNAZ JAHANGIR
IInd YEAR MDS
DEPT. OF ORTHODONTICS
NICDS

CONTENTS
INTRODUCTION
DIGITAL IMAGING
Image enhancement
Digital Subtraction radiography
DIGITALISED SURFACE IMAGING
DIGITAL CAST
Holography
E Models
TMJ ANALYSIS AIDS
3d Jaw Tracing Device
3d Ultrasound
Arthroscopy
Thermography

CONTENTS
COMPUTED TOMOGRAPHY
Dual Energy CT
Micro CT
CBCT
RAPID PROTOTYPING
Stereolithography
Fused deposition modelling
Selective laser sintering
Ink jet printing
IMAGING SOFTWARE
Dolphin software
Nemoceph software
CONCLUSION
REFERENCES

• Proper diagnostic procedure and interpretation of pertinent diagnostic
aids are the basis of the comprehensive orthodontic therapy.
• Orthodontic diagnostic aids are of two types.
INTRODUCTION
ESSENTIAL
• Considered important for all cases.
• Simple
• Do not require expensive equipment's.
SUPPLEMENTAL
• Not essential in all cases.
• Require specialized equipment's

• Modern technical advances and efficient armamentarium provides the
dentist with excellent therapeutic tools for diagnosis.
• Advantages includes,
Reduce patient radiation exposure
Decreases storage needs
Transmission of images.
Organization of data (CT and MRI imaging)
Payyapilly, D.J., Skaria, J., Ayshakunju, A. and Reghunathan, N., Recent Advances in Orthodontic Diagnostic
Records-A Review

• Accurate images of the craniofacial region are critical for the
development of an orthodontic diagnosis and treatment plan.
• Digital processes have improved the diagnostic capabilities of the
imaging tools being used in dentistry and orthodontics
DIGITAL IMAGING
Hatcher, D.C. and Aboudara, C.L., 2004. Diagnosis goes digital. American journal of orthodontics and
dentofacial orthopedics, 125(4), pp.512-515.

Analog image
• Collection of virtually an infinite number of elements.
• Each element represented by a continuous gray scale.
E.g. Radiographic film
Digital image
• Matrix of square pieces or picture elements (pixels).
• Form a mosaic pattern from which the original image can be
reconstructed for visual display.
Stuart, C., WHITE, P. and MICHAEL, J., 2014. Oral Radiology: principles and interpretation. ELSEVIER INDIA.

CHARACTERISTIC OF DIGITAL IMAGE
Silver halide grains of radiographic film are replaced by small
light- sensitive electronic sensors
It produce an electric signal depending on the voltage recorded
by the sensor.
A digital image is composed of picture elements (pixels) that are
arranged in a 2-dimensional rectangular grid

DIRECT
a) Solid state detector
b) Photostimulable Phosphor plate
INDIRECT
a) Charged Coupled Device
b) Complementary metal oxide semiconductor
c) Charge injection device.

Process by which the editing and improvements of original image can be
performed.
 Applied to make image visibility more appealing.
 Can be enhanced by increasing contrast, optimizing brightness, color
 Digital subtraction radiography can also be done.
IMAGE ENHANCEMENT

• Subtraction in digital radiography is another image enhancement method.
• When 2 images of the same area in the mouth are registered and the
image intensities of the corresponding pixels are subtracted, a uniform
difference image is produced.
DIGITAL SUBSTRACTION RADIOGRAPHY
Raghavendra Sunku, R.R., Kancherla, P., Perumalla, K.K., Yudhistar, P.V. and Reddy, V.S., 2011. Quantitative digital subtraction
radiography in the assessment of external apical root resorption induced by orthodontic therapy: a retrospective study. The
Journal ofContemporary Dental Practice, 12(6), pp.422-428.

• The 1st image can be subtracted from the 2nd one to identify changes
that may have occurred during a certain time period.
• If there is a change seen between pre and follow up examination,
these changes show up as loss or gain of hard tissues.

 About 50% - 70% less radiation than conventional radiography
 Immediate picture
 Elimination of darkroom, film, and chemical processing
 Easy to share by digital networking
 Easy to store.
 Easy for client education.
Advantages of Digital Imaging

• Recently digitalized surface imaging have replaced traditional
photography method.
• To obtain two similar images in the same position is unlikely by
traditional photography method due to change in camera angle and
head position
DIGITALIZED SURFACE IMAGING
Erten, O. and Yılmaz, B.N., 2018. Three-Dimensional Imaging in Orthodontics.

Surface structure is obtained by
• Geometry is constructed by using xyz coordinates
• Colour texture is added

• Surface imaging can be obtained by 3 methods
LASER LIGHT:
• They use laser beam across the surface area of the object
• The object scatter light which is collected at a known triangulation
distance from laser by using xyz coordinates
• Colour texture is obtained from point cloud of information

STRUCTURED LIGHT:
• Structured lights projects organized pattern of white light in the form
of grid ,dots ,stripes on subject.
• Simultaneously photographing the subject with a camera that is
calibrated with the specifics of the projected light pattern
• Depending upon the distortion of the light pattern the image is
obtained.

STEREOPHOTOGRAMMETRY:
• Its is sophisticated method where two pictures are taken of the same
object at a similar distance to create a stereotype pair and measure
the depth.
• It is based on stereo triangulation algorithms .
• Lighting can be of two types
Passive
Active

 Less time
 It can be used to evaluate the progress of the treatment
 It can incorporated along with the CBCT
Advantages of 3D Surface Imaging
Hajeer, M.Y., Millett, D.T., Ayoub, A.F. and Siebert, J.P., 2004. Current Products and Practices:
Applications of 3D imaging in orthodontics: Part I. Journal of orthodontics, 31(1), pp.62-70.

• Invented by physicist Dennis Gabor in 1971
• Work of Leithand and Upatneik introduced it into dentistry
• Holography uses laser light to reproduce a very high quality, three
dimensional image. The recorded image is called a HOLOGRAM.
• They permit three dimensional model analysis, superimpositions &
storage
HOLOGRAPHY
Romeo, A., 1995. Holograms in orthodontics: a universal system for the production, development, and
illumination of holograms for the storage and analysis of dental casts. American Journal of Orthodontics
and Dentofacial Orthopedics, 108(4), pp.443-447.

• Laser beam splits into two
different medium of light
• One illuminates the object and
other illuminate recording
medium
• Interference pattern is obtained
in holographic plate
Romeo, A., 1995. Holograms in orthodontics: a universal system for the production, development, and
illumination of holograms for the storage and analysis of dental casts. American Journal of Orthodontics
and Dentofacial Orthopedics, 108(4), pp.443-447.

 Superimposition of images is possible.
 Ease in storage, transportation
Advantages of Hologram
Disadvantages of Hologram
 Inability to place the holograms immediately next to the patient’s
mouth to make side by side comparisons.
 Cannot be adjusted once made

The biomechanics of rapid maxillary sutural expansion
Braun, S., Bottrel, J.A., Lee, K.G., Lunazzi, J.J. and Legan, H.L., 2000. The biomechanics of rapid maxillary
sutural expansion. American Journal of Orthodontics and Dentofacial Orthopedics, 118(3), pp.257-261.

• Digital cast models can be produced by either direct or indirect
techniques.
• Direct methods use interior scanners
• Indirect methods use either laser scanning or computed tomography
imaging of the impressions or plaster models.
• Scans are converted into digital images that are stored on the
manufacturer's servers
DIGITAL CAST
Rakosi, T., Jonas, I. and Graber, T., 1993. Orthodontic diagnosis. Color atlas of dental medicine. Stuttgart,
Germany, and New York, NY: Thieme.

• There are two basic methods of producing digital study models:
• Destructive imaging:
Removes part of a cast, little at a time, while it is being imaged.
• Non destructive imaging:
Uses structured light, laser light to image while leaving the
original cast intact.

Two major successful companies in producing high quality
3-D models
• Ortho Cad is a patented computer model system that creates digital
images of dental casts.
• To obtain the digital images
• The orthodontist sends alginate impressions and a wax bite to the
OrthoCAD laboratory.
• The impressions are scanned, converted into digital images that are
stored on the company’s server, and made available for downloading
by the account holder.
Joffe, L., 2004. Current products and practices OrthoCAD™: digital models for a digital era. Journal
of orthodontics, 31(4), pp.344-347

• Geodigm e-models are constructed through a proprietary laser
scanning process that digitally maps geometry of patient’s anatomy
into a high dimensional 3-D image, with an accuracy of 0.1 mm.
• Scanners project a laser stripe on surface of cast and use digital
cameras to analyze distortions in stripe.
• The cast is oriented in all axes to expose for scanning and are
connected into thousands of triangles to form the 3D image.
Rheude, B., Lionel Sadowsky, P., Ferriera, A. and Jacobson, A., 2005. An evaluation of the use of digital study
models in orthodontic diagnosis and treatment planning. The Angle Orthodontist, 75(3), pp.300-304.

• Using models, clinician can move, rotate, or zoom in any plane or
orientation. Point to point, Bolton analysis, and curve length
measurement

• Colour bite mapping features permit analysis of occlusal relationships,
3D colour coded map demonstrates occlusal content between arches.

• One of the latest developments is E Plan, which simulates multiple
treatment plans to help determine most effective treatment.
• It also allows simulation of rotation movements and allows patient to
view their own teeth from malocclusion to a post treatment view.

 Elimination of model breakage
 Eliminates storage problems
 Instant retrieval of models
 Ease of communication with patients and colleagues
 Model access from many locations.
 Enables transmission of images.
Advantages of Digital Study Models

Digital casts in orthodontics: a comparison of 4 software systems
• An article published by Anna Westerlund and Weronika in AJO
compared with different digital system
1. Ortho cad
2. O3DM
3. Digital model
4. Ortho analyzer
Result :
• All 4 systems were similar regarding services and features and they
found ortho Cad and O3 DM to be easy for beginners.
Westerlund, A., Tancredi, W., Ransjö, M., Bresin, A., Psonis, S. and Torgersson, O., 2015. Digital casts in
orthodontics: a comparison of 4 software systems. American Journal of Orthodontics and Dentofacial
Orthopedics, 147(4), pp.509-516.

• The concept of computerised occlusogram was introduced by
Burnstone in 1969.
• Basic principles includes
 Image scanning and setting
 Occlusal view processing
 Lateral cephalometric processing
 Occlusogram construction.
3D OCCLUSOGRAM
Fiorelli, G. and Melsen, B., 1999. The “3-D occlusogram” software. American journal of orthodontics
and dentofacial orthopedics, 116(3), pp.363-368

Image scanning and setting :
• Images of occlusal surface and lateral ceph is scanned.
Occlusal view processing :
• Occlusal relationship between upper and lower arch is marked by 2
point occlusal contact.
• Symmetry line for both upper and lower arch is selected and should
coincide with the midline in the anterior region.

Lateral cephalometric process:
• Occlusal plane is constructed using the lateral ceph view
3D Occlusalgram construction:
• With help of spatial combination of lateral ceph and occlusion relation
of upper and lower arch the 3 dimensional set up is made.

 Evaluate anchorage requirement
 Arch length status
 Final arc width
 Teeth to be removed
Uses

Evaluation of occlusal contacts among different groups of malocclusion
using 3D digital models
• An article published by Rayez Et Al supported the usage of 3d
occlusogram for creating 3d digital models
Result :
• Greater occlusal contact point for class 1 malocclusion ,least for class 3
malocclusion
Al-Rayez , N.Z. and Hajeer, M.Y., 2014. Evaluation of occlusal contacts among different groups of
malocclusion using 3D digital models. The journal of contemporary dental practice, 15(1), pp.46-55.

• Makes use of infrared rays
• When the frequency of the IR is the same as the vibrational frequency
of the material, absorption occurs.
• Examination of the transmitted light reveals how much energy was
absorbed at each frequency .
• This measurement can be achieved by scanning the wavelength range
using a monochromator.
INFRARED SPECTROSCOPY

Determination of Microelements from Orthodontic Implants by the
Flame Atomic Absorption Spectroscopy Method
• A study was conducted by Szuhanek Et Al to evaluate the micro
elements in the micro implant using absorption spectroscopy method
Result :
• The basic study concluded the micro implants containing titanium and
aluminium had better corrosion resistance and biocompatibility and
low cytotoxicity
Szuhanek, C. and Grigore, A., 2015. Determination of Microelements from Orthodontic Implants
by the Flame Atomic Absorption Spectroscopy Method. Rev. Chim.(Bucharest), 66, p.1600.

3D JAW TRACKING DEVICE
• It records the mandibular
movement in all 3 dimensions.
• A small magnet is attached to
labial of mandibular incisor and
the movement is tracked with help
of sensors.
• The device is attached to head.
Airoldi, R.L., Gallo, L.M. and Palla, S., 1994. Precision of the jaw tracking system JAWS-3D. Journal of
orofacial pain, 8(2).

• Most 3D ultrasound imaging systems make use of conventional 1D
ultrasound transducers to acquire a series of 2D ultrasound images.
3D ULTRASOUND
Sharma, et al.: Ultrasound in Dentistry International Journal of Scientific Study | May 2014 | Vol 2 | Issue 2
applications in image-guided neurosurgery as an alternative approach to open magnetic resonance (MR)and
intra interventional computed tomography (CT).

 Multiple imaging planes and allows accurate measurement.
 It offers both the diagnosis and in guidance for minimally invasive
therapy.
 Low cost and simplicity of use
Advantages of 3D Ultrasound

ARTHROGRAPHY
• Radiographic invasive technique.
• Uses a radio opaque substance (Tc99
/ Ba ).
• Injected into joint space to enhance
contrast between disc and space.
• Recently arthroscopic procedure was
done by dr srouji were instead of 3
port system a single cannula port was
used which contain a visualizing canal
,irrigation canal and a working canal.
Srouji, S., Oren, D., Zoabi, A., Ronen, O. and Zraik, H., 2016. Temporomandibular joint arthroscopy
technique using a single working cannula. International journal of oral and maxillofacial surgery, 45(11),
pp.1490-1494.

• The principle of thermography is based on the amount of blood
circulation at different layers of the skin which varies, the temperature
also changes accordingly.
• Consequently, disorders that affect the blood flow too result in
abnormalities in temperature distribution and these when evaluated
will provide valid diagnostic information.
• Usually thermography is done using infrared rays.
THERMOGRAPHY
McBeth, S.B. and Gratt, B.M., 1996. Thermographic assessment of temporomandibular disorders symptomology
during orthodontic treatment. American journal of orthodontics and dentofacial orthopedics, 109(5), pp.481-488.

Various orofacial conditions in which thermography can be used are
 Chronic orofacial pain
 TMJ disorders,
 Quantification of thermal insult to pulp,
 Assessing inferior alveolar nerve deficit
McBeth, S.B. and Gratt, B.M., 1996. Thermographic assessment of temporomandibular disorders symptomology
during orthodontic treatment. American journal of orthodontics and dentofacial orthopedics, 109(5), pp.481-488.

• In dentistry MRI was first used for imaging the TMJ by Helms et al in
1984
• In orthodontics the first MRI study of TMJ following Herbst appliance
therapy was published in 1998.
• MRI uses non-ionizing radiation from the radiofrequency band of the
electromagnetic spectrum.
MAGNETIC RESONANCE IMAGING (MRI)
Patel, A., Bhavra, G.S. and O’neill, J.R.S., 2006. MRI scanning and orthodontics. Journal of orthodontics, 33(4),
pp.246-249.

• To produce an MR image, the
patient is placed inside a large
magnet field loaded machine ,
which induces a relatively strong
external magnetic field.
• This causes nuclei of many atoms
in the body including hydrogen,
to align themselves with the
magnetic field.
PRINCIPLE :
pp.246-249.

• ENEGRY released by this transition is used as a signal to form image.
• When images are displayed; intense signals show as white and weak
ones as Black and Intermediate as shades of gray.
• Cortical bone and teeth with low presence of hydrogen are poorly
imaged and appear black.
pp.246-249.

• MRI has proved useful in orthodontics particularly in the study of TMJ.
– To study the mandibular condylar position.
– To correlate TMJ sounds recorded by sonography with condyle / disk
relations on MRI.
– TMJ disorders in juvenile patients.
– TMJ internal derangement and craniofacial morphology.
– Estimate tongue volume and correlate with body weight.
– Evaluating jaw muscles and craniofacial morphology in normal patients and
after functional appliance therapy
USES
Shah, A., 2018. USE OF MRI IN ORTHODONTICS-A REVIEW. Guident, 11(10).

• Hounsfield (1972) invented the first CT technique, which he called
“ computerized axial transverse scanning”.
• CT scan provides high contrast resolution and demonstrate small differences
in soft tissue density, therefore very useful for the diagnosis of diseases in
the maxillo-facial complex.
• Spiral/helical CT scanners generate adequate image to create 3D images with
less scanning time and less radiation compared with conventional CT scan.
COMPUTED TOMOGRAPHY (CT)

• The CT image is recorded and displayed as a matrix of individual blocks
called voxels (volume elements).
• 3D CT requires each voxel, shaped as a rectangular solid, be
dimensionally altered into multiple cuboidal voxels. This process is
called as interpolation.
• Creation of these new cuboidal voxels allows the image to be
reconstructed in any planes without loss of resolution.
PRINCIPLE :

• Completely eliminates the superimposition of image.
• High contrast resolution
• From single CT imaging, multiple contiguous scans can be viewed as
image in axial, coronal or sagittal planes, depending on the diagnostic
task.
ADVANTAGES

DUAL ENERGY CT
• Spectral CT is based on viewing the same
anatomy at two different kV energies.
• Can be accomplished with a dual-source
CT scanner, or newer methods that either
use fast kV switching between different
energies during the scan, or detector
elements that record different kV levels
during a scan.
Schneider, U., Pedroni, E. and Lomax, A., 1996. The calibration of CT Hounsfield units for radiotherapy
treatment planning. Physics in Medicine & Biology, 41(1), p.111.

MICRO CT
• Principally the same as CT, except
that the reconstructed cross sections
are confined to a much smaller area
• Reduction in radiation dose
• It measure the bone connectivity in
all 3 planes
Honda, K., Arai, Y., Kashima, M., Takano, Y., Sawada, K., Ejima, K. and Iwai, K., 2004. Evaluation of the
usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid
fossa of the temporomandibular joint. Dent maxillofacial Radiology, 33(6), pp.391-395.

CBCT
• Introduced by Aboudara et al in
1984.
• It works on 4 basic principles
1. Acquisation configuration
2. X ray production
3. Image detection
4. Reconstruction phase
Kapila, S., Conley, R.S. and Harrell Jr, W.E., 2011. The current status of cone beam computed tomography
imaging in orthodontics. Dent maxillofacial Radiology, 40(1), pp.24-34.

Acquisation configuration
• A single partial/full rotational scan from x ray source rotates along
with the detector in fixed fulcrum axis
Image detection
• By charge coupled device with fibro optic image intensifier
• Amorphous silicon flat panel detector
Reconstruction phase :
• This converts the 2d images obtained at each position during rotation
to a volumetric 3dimensional image
• 100-6002d images are obtained in single rotation
Kapila, S., Conley, R.S. and Harrell Jr, W.E., 2011. The current status of cone beam computed tomography
imaging in orthodontics. Dent maxillofacial Radiology, 40(1), pp.24-34.

 Position of the maxillary incisor roots relative to the lingual cortical
border of the palate to plan retraction.
 Amount of bone in the posterior maxilla available for distalization.
 Amount of bone lateral to the maxillary buccal segments available for
expansion.
Uses
Hechler, S.L., 2008. Cone-beam CT: applications in orthodontics. Dental Clinics of North America, 52(4),
pp.809-823.

 Airway information on the pharynx and nasal passages
 Maxillary root proximity to the maxillary sinus
 Position of the mandibular incisor roots in bone.
 Allow 3D visualization of bony defects and supernumerary teeth in
patients with cleft lips or palates.
 Visualisation of TMJ
Hechler, S.L., 2008. Cone-beam CT: applications in orthodontics. Dental Clinics of North America, 52(4),
pp.809-823.

CT Vs CBCT
X-Ray source is a high output
rotating anode generator.
Uses a fan shape X-Ray
beam.
Image sensors used solid
state detectors arranged in a
360 degree array around
patient
In contrast to CT it uses a low
energy fixed anode tube
similar to that used for OPG
machines.
Uses a cone shaped X-Ray
beam.
The image sensors used are
special image intensifier &
solid state sensor.

• Rapid prototyping (RP) broadly indicates the fabrication of a three-
dimensional (3D) model from a computer aided design (CAD),
traditionally built layer by layer according to the 3D input.
• RP additive nature allows it to create objects with complicated internal
features and external morphology.
RAPID PROTYPING
Kumar A, Ghafoor H. Rapid prototyping: A future in orthodontics. J Orthod Res 2016;4:1-7

Data is obtained from MRI/CT scan slice
images.
Software packages “slices” the CAD model into
a number of thin (–0.1 mm) layers, which are
then build up one on top of another
highly accurate models

STEREOLITHOGRAPHY
• Due to its accuracy and surface finish, it
has become the most popular among RP
methods.
• This technique builds 3D polymer from
the photosensitive liquid resin that
solidify when exposed to the ultraviolet
(UV) laser.
Kitai, N., Yasuda, Y. and Takada, K., 2002. A stent fabricated on a selectively colored stereolithographic
model for placement of orthodontic mini-implants. The International journal of adult orthodontics and
orthognathic surgery, 17(4), pp.264-266.

• Recent advances in stereolithography software are called as “quick
cast” is used for building the parts with hollow interiors, which can be
used directly as wax pattern for investment casting.
Kitai, N., Yasuda, Y. and Takada, K., 2002. A stent fabricated on a selectively colored stereolithographic
model for placement of orthodontic mini-implants. The International journal of adult orthodontics and
orthognathic surgery, 17(4), pp.264-266.

FUSED DEPOSITION MODELING
• Filaments of heated thermoplastic
are extruded from a tip that moves in
the X-Y plane.
• Extrusion head deposits thin bead of
materials on to build a platform
which is maintained at low
temperature.
• The layer by layer deposition and
hardening takes place to form the
object

SELECTIVE LASER SINTERING(SLS)
• This technique uses a laser beam to
selectively fuse powdered materials
such as nylon, elastomer, and metal
into solid objects
• It is fabrication involves the use of
nylon composite, investment casting
wax, metallic, ceramic, and
thermoplastic composite.
• It is processed in short time and
produces a minimal thermal distortion.

INK JET PRINTING
• Liquid materials such as liquid
photopolymer resin are filled into the
jetting heads which squirt tiny droplets of
the material as they move in X-Y plane into
the desired pattern to form the layer of the
object
• Advantages of inkjet printing are a fine
resolution, accurate surface finish, and
minimal material consumption

 For diagnosis and treatment plan
 For fabrication of orthodontic appliance
 For fabricating surgical templates
 Lingual orthodontics
Uses Of Protyping

• First concept – Dr.Mark lemchen & Gary Engel
DOLPHIN SOFTWARE
Power, G., Breckon, J., Sherriff, M. and McDonald, F., 2005. Dolphin Imaging Software: an analysis of the
accuracy of cephalometric digitization and orthognathic prediction. International journal of oral and
maxillofacial surgery, 34(6), pp.619-626.

Imaging software accuracy for 3-dimensional analysis of the upper
airway
• A study conducted by Weissheimer Et Al to evaluate the efficacy of
dolphin software to measure the volume in upper airway
Result :
• The results proved that dolphin software had given accurate results
along with other imaging software
Weissheimer, A., de Menezes, L.M., Sameshima, G.T., Enciso, R., Pham, J. and Grauer, D., 2012. Imaging
software accuracy for 3-dimensional analysis of the upper airway. American Journal of Orthodontics and
Dentofacial Orthopedics, 142(6), pp.801-813.

• Some of the studies conducted using dolphin software in the year
2017
 3 dimensional analysis of upper airway morphology in class III patient
(Xiwendel et al)
 Changes in pharyngeal airway and hyoid position after maxillary
protraction (Wang et al)
 Relationship of frontal sinus and anterior occlusion (Omar et al)
 Impact of RME on nasomaxillary complex (Capellet et al)

• Orthodontic imaging has come a long way since the “PLASTER ERA”
during the times of E.H Angle and Calvin case when plaster was
recording medium for dentition as well as facial form.
• We are now in “DIGITAL ERA” in which digital technologies are being
used to resolve previous limitations.
• Continuing evolution in orthodontic imaging and treatment of patients
is such that these techniques will be key to future orthodontic
practice.
CONCLUSION

REFERENCES
• Rakosi, T., Jonas, I. and Graber, T., 1993. Orthodontic diagnosis. Color atlas of dental medicine.
Stuttgart, Germany, and New York, NY: Thieme.
• Stuart, C., WHITE, P. and MICHAEL, J., 2014. Oral Radiology: principles and interpretation. ELSEVIER
INDIA.
• Airoldi, R.L., Gallo, L.M. and Palla, S., 1994. Precision of the jaw tracking system JAWS-3D. Journal of
orofacial pain, 8(2).
• Al-Rayez , N.Z. and Hajeer, M.Y., 2014. Evaluation of occlusal contacts among different groups of
malocclusion using 3D digital models. The journal of contemporary dental practice, 15(1), pp.46-55.
• Braun, S., Bottrel, J.A., Lee, K.G., Lunazzi, J.J. and Legan, H.L., 2000. The biomechanics of rapid
maxillary sutural expansion. American Journal of Orthodontics and Dentofacial Orthopedics, 118(3),
pp.257-261.
• Erten, O. and Yılmaz, B.N., 2018. Three-Dimensional Imaging in Orthodontics.
• Fiorelli, G. and Melsen, B., 1999. The “3-D occlusogram” software. American journal of orthodontics
• Hajeer, M.Y., Millett, D.T., Ayoub, A.F. and Siebert, J.P., 2004. Current Products and Practices:
Applications of 3D imaging in orthodontics: Part I. Journal of orthodontics, 31(1), pp.62-70.

• Hatcher, D.C. and Aboudara, C.L., 2004. Diagnosis goes digital. American journal of orthodontics and
dentofacial orthopedics, 125(4), pp.512-515.
• Hechler, S.L., 2008. Cone-beam CT: applications in orthodontics. Dental Clinics of North
America, 52(4), pp.809-823.
• Honda, K., Arai, Y., Kashima, M., Takano, Y., Sawada, K., Ejima, K. and Iwai, K., 2004. Evaluation of the
usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the
glenoid fossa of the temporomandibular joint. Dent maxillofacial Radiology, 33(6), pp.391-395.
• Joffe, L., 2004. Current products and practices OrthoCAD™: digital models for a digital era. Journal of
orthodontics, 31(4), pp.344-347
• Kapila, S., Conley, R.S. and Harrell Jr, W.E., 2011. The current status of cone beam computed
tomography imaging in orthodontics. Dent maxillofacial Radiology, 40(1), pp.24-34.
• Kitai, N., Yasuda, Y. and Takada, K., 2002. A stent fabricated on a selectively colored stereolithographic
model for placement of orthodontic mini-implants. The International journal of adult orthodontics
and orthognathic surgery, 17(4), pp.264-266.
• Kumar A, Ghafoor H. Rapid prototyping: A future in orthodontics. J Orthod Res 2016;4:1-7.
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