A Critical Review of the Efficacy and Safety of Radiological Imaging Techniques in Pediatric Orthodontics

Radiological imaging plays a pivotal role in pediatric orthodontics, facilitating precise diagnosis, treatment planning, and monitoring of craniofacial anomalies and dental conditions. This narrative review critically evaluates the efficacy and safety of various imaging modalities in pediatric orthodontics, including cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI), digital radiography, ultrasound, and emerging technologies such as artificial intelligence (AI) and low-intensity pulsed ultrasound (LIPUS).

The review examines the literature on the use of different imaging techniques in pediatric orthodontics, focusing on their diagnostic capabilities, radiation exposure, and clinical applications.

While advanced imaging techniques have revolutionized orthodontic care, they present unique challenges, particularly concerning radiation exposure in pediatric patients. CBCT has emerged as an invaluable tool for complex cases, offering detailed three-dimensional visualizations crucial for assessing impacted teeth, skeletal discrepancies, and temporomandibular joint disorders. However, its higher radiation dose necessitates judicious use, guided by the ALARA (As Low As Reasonably Achievable) principle and dose optimization protocols. Alternatives such as MRI and LIPUS provide radiation-free diagnostic and therapeutic options, underscoring their growing role in pediatric orthodontics. Digital X-rays, with lower radiation doses and improved patient comfort, remain essential for routine assessments, while AI-driven technologies enhance diagnostic accuracy and streamline clinical workflows.

The review shows the critical balance between efficacy and safety in pediatric radiological imaging. Innovations in imaging technology, such as ultra-low-dose CBCT and AI-based diagnostic tools, are paving the way for safer, more precise orthodontic care.