## 6 The Use of CBCT in Orthodontics in the Pediatric Population  
A child's body, whose cells are undergoing dynamic divisions, is more vulnerable than an adult to the formation of mutations under X-rays and thus to the potential for the development of tumors. Therefore, it is important to limit exposure to this type of irradiation to the minimum necessary. In the pediatric population, the so-called \"ALARA principle\" (As Low As Reasonably Achievable) applies, which refers to ensuring that the patient benefits more from the treatment than the potential risk of developing cancer. It includes the highest quality, evaluation of techniques and equipment, and the lowest radiation doses that will provide the necessary diagnostic information [80]. CBCT appears to be an appropriate imaging modality for children and certainly safer in terms of the amount of radiation than standard CT, also considering the much shorter duration of the examination. However, it should be noted that the amount of radiation the patient receives is several times greater than that of a standard 2D image. Moreover, even the short examination time (about 20 s) can be difficult for a child to endure in complete stillness. Even a small twitch of the head, in turn, can result in artifacts on the image and thus reduce its diagnostic value [81, 82]. Some centers are developing new systems to correct and compensate for motion artifacts during the examination, but these technologies are not widely available. Instead, most offices use various types of head stabilizers, which go some way toward minimizing unwanted patient movements. The position in which the examination is performed is also important; it can be standing, lying down, or sitting. According to a study [81] involving 40 children, they tolerated CBCT best when performed in the supine position, with a foam headrest as head support. The younger the age, the higher the risk of moving was. CBCT is used in the diagnosis of many conditions in  
Figure 5: Scheme of operation of cone beam computed tomography in imaging the jaws and mandible. The arrows showed the magnetic field direction. pediatric orthodontics. Some of the most common cases evaluated include an ectopic maxillary canine, retained second premolars, dental root resorption, cleft palate, the effects of trauma in the orofacial region, or supernumerary teeth. CBCT also plays a key role in preparing for surgery, tooth extraction, implant placement, and orthodontic treatment planning, as well as monitoring the course of applied therapies [80, 81, 82, 83]. Specific studies using CBCT as a 3D imaging method before and during orthodontic treatment in children are cited below. A study by [PERSON] et al. [84] compared the results of imaging unilateral or bilateral retained maxillary canines in 20 patients using periapical, occlusal, panoramic, and CBCT X-rays. It turned out that by analyzing CBCT images, orthodontic specialists made the same diagnoses regarding the position of retained canines and the presence of resorption of adjacent dental roots. Using conventional radiographs, these descriptions differed. This study shows the advantage of CBCT in objectifying descriptions of malocclusion, in this case retained amines, which is crucial for successful orthodontic treatment. In another study, [PERSON] et al. [85] conducted a comparison of treatment plans for external cervical resorption (ECR) developed from periapical radiographs (PA) and CBCT. Concordance between evaluating specialists was uniformly higher for CBCT imaging, and treatment plans developed from CBCT scans differed from those created from PA radiographs in 56.7% of cases. These results also indicate the superiority of CBCT over PA when evaluating external cervical resorption. On the other hand, a study by [PERSON] et al. [86] used CBCT to determine differences in central incisor root volumes in patients with unilateral cleft lip and palate (UCLP) between the side with cleft and the healthy side, as well as compared to patients forming a control group without UCLP.