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According to “Dr. Wo” Wm. Randol Womack, DDS, Board Certified Orthodontist Editorial Director, Orthotown Magazine

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CBCT, Context and Conferences
by Wm. Randol Womack, DDS, Board Certified Orthodontist
Editorial Director, Orthotown Magazine

Orthotown Magazine has focused on cone beam computed tomography (CBCT) as one of its major topics since our very first issues. The impact of CBCT scans in diagnosis and treatment planning is becoming more recognized and adoption of this technology is becoming an important decision within and amongst orthodontic practices. I try to make it a point to attend as many meetings as I can when 3D imaging is the main focus.

The Imaging Sciences International Congress on 3D Dental Imaging is now in its sixth year. I started attending in its third year and I am registered for the next one, which will be in October this year. There are 11 outstanding speakers who will be sharing their perspective on the theme: “Moving from 2D to 3D Treatment Planning.”

The other meeting that I have attended since its inception is the Anatomage Users Group Meeting. The third annual meeting was in April and I had the privilege of sharing the platform with those much more expert than I in the application of CBCT images in orthodontics, including Dr. David Hatcher, among others. My presentation was “The Clinical Application of InVivo 5 Software.”

Dr. Hatcher’s presentation focused on the sinus images that are so clearly viewed in a CBCT scan. He reviewed the navigation through the InVivo 5 Software in viewing the sinuses. He provided a step-by-step process of how to do this and what structures can be visualized that are “normal,” with the idea that anything seen that does not match what a “normal” structure should look like needs to be reviewed by an oral and maxillofacial radiologist (OMR). Dr. Hatcher is sought after by many organizations to contribute to the understanding of the images we can view in a CBCT scan.

One of the most factual and entertaining presentations at the Anatomage users meeting was done by Art Curley, a senior trial attorney in a San Francisco-based health-care defense firm. Mr. Curley has been a speaker at this meeting before and his experiences with legal cases involving the use or non-use of CBCT is very enlightening. Mr. Curley has spoken at other Anatomage users meetings and his viewpoint as seen from the courtroom is extremely informative. He emphasized that record keeping of items, often not considered relevant, is seriously important relative to CBCT imaging. He recommended recording in a journal, the time and date of regular calibrations of your CBCT machine. This is information that needs to be retained to assure the accuracy of scans. According to his experiences, a dentist/orthodontist is more likely to be sued for not taking a CBCT scan. One statement that really made me think is that treatment of a family member requires an informed consent in the treatment record. “Family is not excluded,” he stated. He emphasized documenting everything, like when your patient watched a video, and when you gave instructions for retainers, you should mark the time of day as well as the date when an informed consent is signed, etc. Also record negative issues, hygiene, failed or cancelled appointments, etc.

We will continue to bring you the latest updates relative to CBCT so you can make an informed decision about the use and value of CBCT, and I would encourage each of our readers to look for opportunities to learn more about this technology.
Orthotown Magazine
September 2025
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