Cone-Beam Computed Tomography Integration in Clear Aligner Treatment Planning: Practices and Perceptions Among Orthodontists and General Practitioners

Objectives: This study assesses the practices and perceptions of orthodontists (OT) and general dentists (GP) regarding the importance and usage of Cone-Beam Computed Tomography (CBCT) integration in orthodontic treatment planning.
Methods: Practitioners from Canada, Brazil, and Spain who provide orthodontic treatment were invited to participate. A web-based survey assessed the CBCT integration to ClinCheck^® during Clear Aligner Treatment (CAT) planning. The data collected were analyzed by descriptive statistics, as well as bivariate and regression analysis.
Results: A total of 315 clinicians participated in the study, with 92.9% providing CAT and a median of 300 cases treated annually. CBCT scans were commonly used for specific cases in initial orthodontic records (OT: 73%, GP: 54%) while CBCT integration was utilized by 51% of OT and 77% of GP. Most users reported confidence in diagnosis and treatment planning with the integration tool, particularly for evaluating impacted teeth (OT: 91%, GP: 100%, OR: 100%) and planning dental expansion (OT: 76%, GP: 100%, OR: 57%). Nearly 90% of participants found the integration useful in treatment decision-making, with 75% of OT indicating it could alter treatment plans. Clinicians with higher CAT case volumes were significantly more likely to use CBCT integration (p=0.03).
Conclusions: The participants declared confidence in their diagnosis and treatment planning capabilities when using CBCT integration, specifically for adults, complex cases, and impacted teeth. Cost and ionizing radiation exposure were identified as barriers to broader adoption. The integration is shown to improve communication with patients and treatment outcomes.