Avoiding radiation risks from dental cone-beam computed tomography imaging in orthodontic patients

Document Type : Original Article


1 Nuclear and Radiological Regulatory Authority, (NRRA), P.O. 7551, Nasr City, Cairo, Egypt

2 Department of Orthodontics, Faculty of Oral and Dental Medicine, Future University, Cairo, Egypt


Although CBCT has several advantages, it has a huge disadvantage regarding the amount of exposure dose associated with its diagnostic assessment. The risks associated from using CBCT can be avoided by using another safe technique which is the Digital Smile Design (DSD). DSD is a globally procedure depending on definite photographs and software analysis. In the present study, DSD had been used as a substituted technique instead of CBCT to avoid radiation hazards accompanied by using CBCT and get a full understanding of smile features helping in diagnosis and treatment planning for maximum patient satisfaction. This study was carried out on patient adults from Class III and Class I. Two frontal digital photographs were taken for each subject, one at rest and the other in the posed smile position. Photographs were uploaded on Photoshop software for standardization and a reading for the incisogingival height of the right maxillary central incisor was done. The ratio of 7:5 was found to provide the most accurate image guided by the actual clinical height of the central incisor. The new standardized photos were uploaded on the DSD to be calibrated and measure all linear variables. It is found that Class III patients tended to have wider smile widths, less gingival display, longer chin heights, shorter lower vertical dimensions and a higher percentage of non-consonant and flat smile arcs than Class I subjects. We concluded that the smile components estimated from DSD are almost typical to those obtained from CBCT, without exposure to radiation doses.