CONE BEAM COMPUTED TOMOGRAPHIC ASSESSMENT OF THE DISTANCE BETWEEN THE INCISIVE CANAL AND MAXILLARY CENTRAL INCISORS

Abstract

Background Maxillary anterior teeth play an important role in aesthetics, phonetics, and mastication. Because of the aesthetic and functional significance, it is important to evaluate their position in association with surrounding structures in 3-D before initiating orthodontic treatment. With the advent of cone beam computed tomography (CBCT) in orthodontic diagnosis, it is now possible to identify these structures. One such structure is the incisive canal. Uncertainty in locating the canal can cause root resorption postorthodontic retraction of anterior maxillary teeth. Objective(s) The aim of this study was to calculate the relative distance between the incisive canal and maxillary central incisor using CBCT and utilize the results for orthodontic treatment planning. Study Design All quantitative measurements between the incisive canal and both maxillary central incisors were performed using CBCT on 61 patients. The anteroposterior measurements were taken on both sides, and the average of both values was considered for the statistical analysis. The Steiner cephalometric analysis was performed to select patients with skeletal and dental Class I relationship. All linear measurements were performed on the axial plane at 3 different vertical reference points located on the sagittal plane: (1) the palatal opening of the incisive canal (opening level, P1), (2) midlevel between the opening level and the root apex of the maxillary central incisors (midlevel, P2), and (3) the root apex of the maxillary central incisors (root apex level, P3). Results The average anteroposterior distance between the maxillary central incisor roots and the incisive canal was approximately 56 mm. Discussion/Conclusions The results of our study could be clinically helpful to plan orthodontic treatment that requires significant retraction of maxillary incisors. The authors support the idea of a pretreatment CBCT in cases that require maximum anterior retraction in the maxilla. Maxillary anterior teeth play an important role in aesthetics, phonetics, and mastication. Because of the aesthetic and functional significance, it is important to evaluate their position in association with surrounding structures in 3-D before initiating orthodontic treatment. With the advent of cone beam computed tomography (CBCT) in orthodontic diagnosis, it is now possible to identify these structures. One such structure is the incisive canal. Uncertainty in locating the canal can cause root resorption postorthodontic retraction of anterior maxillary teeth. The aim of this study was to calculate the relative distance between the incisive canal and maxillary central incisor using CBCT and utilize the results for orthodontic treatment planning. All quantitative measurements between the incisive canal and both maxillary central incisors were performed using CBCT on 61 patients. The anteroposterior measurements were taken on both sides, and the average of both values was considered for the statistical analysis. The Steiner cephalometric analysis was performed to select patients with skeletal and dental Class I relationship. All linear measurements were performed on the axial plane at 3 different vertical reference points located on the sagittal plane: (1) the palatal opening of the incisive canal (opening level, P1), (2) midlevel between the opening level and the root apex of the maxillary central incisors (midlevel, P2), and (3) the root apex of the maxillary central incisors (root apex level, P3). The average anteroposterior distance between the maxillary central incisor roots and the incisive canal was approximately 56 mm. The results of our study could be clinically helpful to plan orthodontic treatment that requires significant retraction of maxillary incisors. The authors support the idea of a pretreatment CBCT in cases that require maximum anterior retraction in the maxilla.