Authors' response

Abstract

Thank you for the interest in our article. We agree with the comment that cone-beam computed tomographic (CBCT) imaging provides more accurate information and we never contradicted that fact. Radiation dosage with the use of x-rays should benefit the patient and simultaneously provide the dentist with accurate information, which is the reason for principles such as ALARA (as low as reasonably achievable) turning to ALADA (as low as diagnostically acceptable).1Jaju P.P. Jaju S.P. Cone-beam computed tomography: Time to move from ALARA to ALADA.Imaging Sci Dent. 2015; 45: 263-265Google Scholar The purpose of our study was to examine to what extent angulation and sector position in palatally displaced canines (PDCs) differed between the panoramic radiograph and the CBCT image. We found that angulation and sector position deviated, but clinically the differences were modest. Overlap in frontal view to determine the sector position and angulation of PDC to midline was not hard to pin down in the panoramic radiographs, and these references have been used widely in the literature on interceptive treatment of PDCs. The lateral incisors near the PDC do not always have shorter roots.2Brin I. Becker A. Shalhav M. Position of the maxillary permanent canine in relation to anomalous or missing lateral incisors: a population study.Eur J Orthod. 1986; 8: 12-16Google Scholar The main conclusion to draw from the article is that CBCT should not be used routinely for diagnosis of PDC. The decision making regarding interceptive extraction of deciduous canines in PDC cases could be undertaken with the use of panoramic radiographs at an early age, around 10-11 years.3Bazargani F. Magnuson A. Lennartsson B. Effect of interceptive extraction of deciduous canine on palatally displaced maxillary canine: a prospective randomized controlled study.Angle Orthod. 2014; 84: 3-10Google Scholar There are cases, however, where CBCT is indicated, for example, if there is suspicion of root resorption or lesions that could result in a change of therapy. Despite the shortcomings of a panoramic radiograph, it is a diagnostic tool that could be considered good enough for rendering PDC position when CBCT is not crucial for treatment planning, in line with the principle of ALADA. Accord between cone-beam computed tomographic images and panoramic radiographsAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 155Issue 6PreviewI read the article “Are panoramic radiographs good enough to render correct angle and sector position in palatally displaced canines?” in the March issue (Björksved M, Magnuson A, Bazargani SM, Lindsten R, Bazargani F. Am J Orthod Dentofacial Orthop 2019;155:380-7). I appreciate and congratulate the authors for their profound and immense contribution in highlighting the sector analysis for palatally displaced canines (PDCs) in panoramic imaging and comparing that with cone-beam computed tomographic (CBCT) scans. Full-Text PDF