Abstract
BackgroundThe use of CBCT exam in the study of IMC is not new. However, it’s still not known in what specific aspects CBCT exam shows a better result than then conventional exams. The aim of this study was to compare and conclude in what way the opinion regarding upper canine impaction differed when observing a panoramic image compared to the observation of a set of CBCT reconstructions.Material and MethodsTwenty patients (10 males and 10 females) with a total of 28 impacted maxillary canines were identified from the database of the Department of Dentistry, Faculty of Medicine, University of Coimbra. For each canine, two different images were available: a panoramic image and a set of CBCT reconstructions. After a random distribution of both groups images, nine orthodontists completed a questionnaire where they were asked to evaluate ten different questions regarding canine impaction. Statistic analysis was performed using Cronbach’s alpha statistics, Kappa statistics and McNemar test, considering p<0,05 statistically significant.ResultsThis study showed differences between the two images regarding tooth position. A statistical significant poor agreement was found between the two methods for the mesio-distal position of the apex (k=0,388, p<0,001) and for the labio-palatal tip cusp position (k=0,035, p=0,114). The adjacent root resorption showed a poor and very poor agreement between the two methods. Every other items were scored with an agreement between modalities ranging from moderate to strong.ConclusionsThe analyses of panoramic images versus CBCT images reconstructions provided different information regarding tooth position (especially concerning the mesio-distal apex position and the labio-palatal cusp position) but also in the assessment of root resorption. Further investigation should be done to determine in what cases CBCT exam has a clear advantage over conventional 2D exams, justifying its use. Key words:Cone-Beam Computed Tomography, Orthodontics, Impacted Tooth, Root resorption.
Highlights
An impacted tooth might be defined as a tooth that has failed its eruptive movement, from its development location in the alveolar process into its proper location in dental arch within its normal period of growth and development, and that it won’t apparently full erupt based on clinical or radiographic assessment [1,2,3]
For both panoramic image and Cone Beam Computed Tomography (CBCT) reconstructions, there were almost zero cases classified as “NA”, suggesting that both exams allow the determination of the vertical cusp position
A significant decrease of “NA” classification was observed with CBCT data set compared to panoramic images, where, to Wriedt et al [5] study, more than third of the cases were scored as “NA”, suggesting that this data provides a better assessment of L-P cusp position
Summary
An impacted tooth might be defined as a tooth that has failed its eruptive movement, from its development location in the alveolar process into its proper location in dental arch within its normal period of growth and development, and that it won’t apparently full erupt based on clinical or radiographic assessment [1,2,3]. The aim of this study was to compare and conclude in what way the opinion regarding upper canine impaction location, adjacent tooth resorption, prognosis, image information, treatment plan and difficulty level could vary when observing a panoramic image compared to the observation of a set of CBCT reconstructions. The aim of this study was to compare and conclude in what way the opinion regarding upper canine impaction differed when observing a panoramic image compared to the observation of a set of CBCT reconstructions. Conclusions: The analyses of panoramic images versus CBCT images reconstructions provided different information regarding tooth position (especially concerning the mesio-distal apex position and the labio-palatal cusp position) and in the assessment of root resorption. Further investigation should be done to determine in what cases CBCT exam has a clear advantage over conventional 2D exams, justifying its use
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