Dutch researchers conducted a systematic review, published in PLOS One, to determine which diagnostic records are vital for making an orthodontic diagnosis and treatment plan. Pointing out that traditionally, dental casts, intra- and extra-oral photographs, 2D radiographs, and clinical measurements are used for this purpose, the researchers wanted to see how recent technological advancements, for example, digitized dental models and 3D imaging, fit into the process—specifically, which records are needed as part of the treatment planning process.

The researchers conducted an electronic search of PubMed, Cochrane, and other databases, and a hand search of the literature published between 1945 and 2012. They identified a total of 17 studies that met the study’s inclusion criteria—patient undergoing orthodontic treatment, where at least two different types of records were compared and outcome variable of the study was a change in treatment plan. Ultimately, only four were rated as high quality, with low risk of bias. The researchers noted that the “limited number of high-quality studies and the differences in study designs, patient characteristics, and reference standard or index test” meant that a meta-analysis could not be conducted.

While the study’s authors conceded that the findings could not help define a minimum record set required for orthodontic diagnosis and treatment planning, they did note that cephalograms are not necessary for planning treatment of Class II malocclusions. They further found that digital models can be used to replace plaster casts and that CBCT radiographs can be indicated for impacted canines.