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.

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.

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.

JCEG  II- The Next Step

The second meeting of JCEG will 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 are invited to attend. The meeting will be organized around the six working groups each headed by a team of JCEG members. Three meeting hours will be scheduled for each of the six topics over a three day period for a total of 18 hours.  Each topic would begin with  an introduction of the topic by the working group leaders. This introduction will be 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 will break into smaller groups  of about 15 people each. Each session will conclude with a one hour meeting of the entire group to build consensus.

Following the protocols established in JCEG I, the group sessions will be videotaped and transcribed. A summary of the proceedings will be sent to the AJO-DO for publication in the Technobytes section.

Updated JCEG II Agenda

Thursday November 12, 2009

Opening Gala at The Glidden House - Dress-Business Attire

6 pm Cocktails-Cash Bar

7 pm Dinner and distribution of index cards to all attendees to solicit discussion   topics for the meeting.

Friday November 13

830am             Welcome and Introductions- Wolstein Auditorium

900am              Superimpositions- Lysle Johnston/Martin Palomo

1000am            Breakout Groups

1100am            Group Discussion and Consensus

12noon             Box Lunch-Provided

Lunchtime Presentation    Registration-Behrents/Baumrind

1pm                        Breakout Groups

2pm                        Group Discussion and Consensus

3pm                        Nomenclature/Terminology-Beeson and Caruso

4pm                        Breakout Groups

5pm                        Group Discussion and Consensus

6 pm Adjourn for the Day

Saturday November 14

900am              3D Morphologic Standards- Larson, Miyashita and Harrel

1000am            Breakout Groups

1100am            Group Discussion and Consensus

12noon             Box Lunch-Provided

Lunchtime Topic Introduction and Preliminary Discussion:  Image Quality and Machine Parameters-Palomo and Caruso will present hardware phantoms and Walker and Magni Image Standards

1pm                        Breakout Groups

2pm                        Group Discussion and Consensus

3pm                        Database of 3D CT images- Dibbets, Baumrind, McNamara

4pm                        Breakout Groups

5pm                        Group Discussion and Consensus

6pm Adjourn for the day

Sunday November 15- This session will be held at the Intercontinental Hotel as a working brunch.

900am               Superimposition-Summary

930am               Registration- Summary

1000 am            Nomenclature/Terminology- Summary

1030am            3D Morphologic Standards- Summary

1100am            Image Quality and Machine Parameters- Summary

1130am            Database of 3D CT images- Summary

12 noon            Adjourn and head back home.