Presentations 2020: Ortho&Paeds

383 - An evidence-based protocol for the management of orthodontic patients undergoing MRI scans.

R Shivam S Rogers N Drage
Presented by: Rachael Shivam
Cardiff Dental Hospital

Introduction: Magnetic Resonance Imaging (MRI) is an imaging modality that uses strong magnetic fields, magnetic gradients and radio waves to produce images of the body. The demand for MRI is steadily increasing as it does not use ionising radiation and has excellent soft tissue contrast. An increasing number of patients requiring MRI scans are presenting at the Orthodontics Department. Certain materials used in fixed orthodontic appliances can affect the diagnostic quality of MRI by producing artefacts. The aim of this project was to create an evidence-based protocol that would standardise the management of orthodontic patients who require MRI scans. Methods: An initial internet search was carried out using Google to check for existing protocols in the UK; none were found. A thorough literature search was then carried out using five well-known electronic databases to explore the evidence available regarding the effects of orthodontic appliances on MRI. This was used to formulate a protocol. Results: Metal components of orthodontic appliances - in particular, stainless steel - have the potential to create unwanted artefacts that can render an image non-diagnostic. The effect of a particular metal component on an image depends on its magnetic properties, shape, position, and orientation, its distance from the region being imaged, and the MRI sequence and sequence parameters used. Conclusion: Using the evidence, a flowchart has been put together to guide the clinician in the clinical management of orthodontic patients requiring MRI scans. Archwires and stainless steel brackets must be removed prior to MRI of the head and neck region. Other components should be assessed on a case-by-case basis. For new patients expected to undergo regular MRI scans of the head and neck region, ceramic brackets should be placed. If the scans are in the region of the oral cavity, bonded retainers should not be placed.
Consent Statement: There are no details on individual patients reported within the abstract.

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