Comparison of infrazygomatic crest bone screw position using a postero-anterior cephalogram versus cone-beam computed tomography: a cross sectional study

Background: The position of infrazygomatic crest bone screws is an important consideration in determining the success of orthodontic treatment. The aim of this study was to compare the position of infrazygomatic crest (IZC) bone screws in relation to skeletal and dental parameters using postero-anterior (PA) cephalograms and cone beam computed tomography (CBCT).Methods: A CBCT scan and a PA cephalogram were taken of 19 patients (8 males; 11 females) after IZC bone screw placement. Each CBCT image was reconstructed and oriented using the CS 3D CBCT software (Carestream Dental LLC, Atlanta, USA) and was subsequently analysed. The landmarks were traced on the PA cephalogram. The angulation of the IZC bone screw was measured with respect to three skeletal and two dental landmarks and compared between the two imaging modalities. A paired t-test was applied to compare the means of different variables between the PA cephalogram and CBCT scan.Results: The results showed no statistically significant difference between the two imaging modalities with respect to four landmarks, i.e., the inter-jugale plane, the mid sagittal plane, the zygomatic arch and the perpendicular long axis to the 1st molar but a small statistically significant difference was seen with respect to measurements from the facial surface of the 1st molar (P & LE; 0.05).Conclusion: The angulation and position of an IZC bone screw are consistent between the two imaging modalities. A PA cephalogram may be used as a substitute for a CBCT scan to reduce the radiation exposure to patients.