The effect of using CBCT in the diagnosis of canine impaction and its impact on the orthodontic treatment outcome

Abstract

Aim: To investigate the added-value of using CBCT in the orthodontic treatment method of maxillary impacted canines and treatment outcome.

Materials and methods: The sample consisted of 118 treated patients. The CBCT group (n = 58) (39 females/19 males with the mean age of 14.3 years) included those with conventional treatment records consisting of panoramic and cephalometric radiographs, intra-and extra-oral photographs, and dental casts and complemented with a CBCT scan for additional diagnostic information. The conventional group (n = 60) (31 females/29 males with mean age 13.1 years) included those with similar conventional treatment records but without CBCT imaging.

Results: There were significant differences in the canine-related variables between both groups. The CBCT group had the higher level of difficulty and more severely displaced canines when compared with the conventional group. However, no significant difference was found between groups either in the number of treatment methods used or in the use of interceptive methods combined with other treatment modalities or choice of extraction versus non-extraction. In terms of treatment success and interval duration, no significant differences were found. However, treatment duration was significantly (4 months) shorter in the CBCT group compared with the conventional group (P = 0.023).

Conclusion: CBCT has been used in cases with more severe symptoms of maxillary canine impaction. The use of CBCT improved the diagnostic capabilities and improved the chances of success in the more difficult cases to a level similar to that of simpler cases treated on the basis of 2D information.

Keywords: Cone-beam computed tomography; cuspid; impacted; teeth.

Figure 1

Panoramic image of a 14-year-old female patient with a bilateral impacted canine, illustrating the reference lines of the vertical canine location (1) Below the level of the cemento-enamel junction of the adjacent lateral incisor, (2) In the cervical third of the adjacent lateral incisor root, (3) in the middle third of the adjacent lateral incisor root, (4) In the apical third of the adjacent lateral incisor root, or (5) above the apical third of the adjacent lateral incisor root as well as the canine angulation measurements (A) To the midline, (B) To the lateral incisor, and (C) To the occlusal plane

Figure 2

Panoramic view illustrating reference lines of canine overlap (sectors) assigned to one of five categories: -1= Distal to the normal position (in the premolar region), 0= Normal position (primary canine), 1= Distal to the long axis of the lateral incisor, 2= Mesial to the long axis of the lateral incisor, 3= Distal to the long axis of the central incisor, or 4= Mesial to the long axis of the central incisor