A link with the past-A promise for the future.

Purpose: To map the transition from 2D cephalometrics to 3D cone beam imaging for assessment of orthodontic outcomes as well as diagnosis and treatment planning. To facilitate the transition from plaster models to 3D digital study casts. 

Significance:

In 2001, the introduction of low cost, low radiation dose, high resolution cone beam computed tomography in clinical orthodontics created the potential for new discoveries in craniofacial biology and facial growth. This technology provides researchers and clinicians with the tools needed to study 3D changes in craniofacial anatomy associated with the growth process and clinical care. In the 20th century, radiographic cephalometry was a pioneering advance that led to many fundamental insights into the effects of orthodontic treatment. CBCT imaging promises similar advances in the 21st century.

In 2010, new low cost scanners are able to digitize plaster models and/or dental impressions to produce digital study casts. The high quality and low cost of these new devices makes the prospect of digital study casts practical for orthodontists interested in keeping pace in the age of technology. However, as with CBCT, the steep learning curve combined with the desire of manufacturers to sell product necessitates a forum for unbiased discussion of the pros and cons of adopting this technology in orthodontics. Therefore, this year JCEG III will also include 3D model scanning in the discussion matrix.

Background-JCEG I

On November 21, 2008, the Joint Cephalometric Experts Group met in Cleveland at the historic Bolton Brush Growth Study Center for two days to discuss the state of the art in 3D CBCT imaging.  In attendance were international leaders in imaging and orthodontics. The meeting resulted the formation of the following working groups:

·      Superimposition --Identify biologically stable and relevant features for superimposition of 3D volumes.

·      Registration- Establish a set fiducial landmarks within the volume to insure the integrity of the image and to allow landmark data derived from the image to be stored in a known coordinate system.

·      Nomenclature/Terminology- Develop a lexicon of terms to describe treatment procedures and coordinate them with the ADA SNOWDENT project. Define relevant terms that can be used by JCEG to describe 3D volume data and orthodontic procedures.

·      3D Morphologic Standards- Combine the existing 3D Bolton Landmark data with surface data acquired from CBCT to create 3D graphical standards that can be used for orthodontic diagnosis and treatment planning-.

·      Image Quality and Machine Parameters -Propose guidelines for hardware, software and the resulting digital images that can be implemented by the ADA Standards Committee 11.6.

·      Database of 3D CT images - Develop and implement a database of 3D images for craniofacial research.

Background JCEG  II

The second meeting of JCEG was be held at the Bolton Brush Growth Study Center, Case Western Reserve University, in Cleveland, Ohio from November 13 to November 15, 2009. All  members of the orthodontic community interested in CBCT imaging were invited to attend. The meeting was organized around the six working groups each headed by a team of JCEG members. Three meeting hours were scheduled for each of the six topics over a three day period for a total of 18 hours.  Each topic began with  an introduction of the topic by the working group leaders. This introduction was followed by a preliminary group discussion to identify important areas to be covered by this working group. Following the introduction and preliminary group discussion we broke into smaller groups  of about 15 people each. Each session concluded with a one hour meeting of the entire group to build consensus.

Following the protocols established in JCEG I and II, the group sessions will be videotaped.

JCEG III Agenda

Wednesday November 10, 2010

Dedication of the Broadbent Institute for Craniofacial Research - Dress-Business Attire

6 pm  Ribbon Cutting Ceremony- Third Floor Bolton Dental Building

   Tour of the Broadbent Institute

730  pm Dinner at the Intercontinental Hotel and distribution of index cards to all JCEG attendees to solicit discussion topics for the meeting. 

Thursday November 11

830am         Welcome and Introductions- Dively Center

900am         Superimpositions- Lysle Johnston/Martin Palomo

1000am        3D Morphologic Standards- Evans Demo

1100am        Registration of images-Hans Demo

12noon        Box Lunch-Provided

1pm             Nomenclature/Terminology

2pm             Database of 3D CT images

3pm             Image Quality and Machine Parameters

4pm             Digital Study Casts- What is the state of the art

6pm Adjourn

Dinner on your own.

Friday November 12

Brunch Provided at the Intercontinental Hotel and meeting will take place at the Intercontinental Hotel on Friday.