The Transverse Dimension: CBCT Treatment Planning in Growing Children

Abstract

Human faces are not growing as wide as they used to. The maxillary component of the craniofacial complex is often narrower than ideal leading to crowding, dental compensations lending to periodontal issues, reduced tongue space, reduced airflow through the nose, and reduced esthetics due to large buccal corridors. It is not possible to accurately assess the skeletal discrepancy clinically, with models, or with traditional pan/ceph images. CBCT imaging allows for far greater accuracy in diagnosis and treatment planning. Treating the transverse discrepancy early allows for a greater component of skeletal correction. In the late mixed or early permanent dentition, it may be preferable to use a bone borne expander to affect a skeletal change, improve nasal airflow, and reduce the negative side effects of tooth borne expanders. This chapter focuses on the importance of the transverse dimension in orthodontic diagnosis and treatment planning. Human faces are growing narrower than they used to, and this can have negative health impacts, not only for the teeth and periodontal structures, but for the whole body. The use of CBCT imaging is necessary to accurately diagnose and treat the transverse dimension. Treatment of the transverse dimension before adulthood is easier due to the patency of the midpalatal suture. Early orthodontic intervention, combined with accurate diagnosis and treatment planning to address deficiencies allows us to avoid extraction of permanent teeth and improve health outcomes.