Introduction:

Cone-beam computed tomography (CBCT) has been popularized in dentistry, including orthodontics. International organizations have published guidelines for the use of CBCT in dentistry. To date, there are no publications that compile and analyze the current guidelines for the use of CBCT in orthodontics. The aim of this narrative review is to analyze the indications for CBCT in orthodontics both in systematic reviews and current guidelines from international organizations.

Materials and methods:

A main search was conducted in PubMed, Web of Science, and Scopus. For the complementary search, the reference lists of the articles included in full text obtained from the main search and official websites of institutions with guidelines for the use of CBCT in orthodontics, were used. The inclusion criteria corresponded to guides on the use of CBCT in orthodontics, and systematic reviews not included in the references of the guides, in English.

Review:

Seven guidelines and one systematic review were found. CBCT is not recommended for routine use or as an initial imaging examination in orthodontics. The uses are mostly for particular cases, in which conventional radiography does not provide the information for a correct diagnosis and subsequent treatment.

Conclusions:

There is a consensus among international organizations regarding the use of CBCT in orthodontics, justifying its use only when it provides a benefit to the patient. CBCT is a reliable diagnostic tool in cases where three-dimensional evaluation is mandatory to take the most appropriate therapeutic decision. New evidence is still lacking in this area, which must consider the principles of optimization and exam justification.

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