Abstract
ObjectivesIn children and adolescents, cone-beam computed tomography (CBCT) is frequently used for localization of unerupted or impacted teeth in the anterior maxilla. CBCT causes a higher radiation dose than conventional intraoral and panoramic imaging. The objective was to analyze the location of impacted canines in a three-dimensional coordinate and thereby optimize the CBCT field-of-view (FOV), for radiation dose reduction.Materials and methodsLocation of 50 impacted maxillary canines of children under 17 years was retrospectively evaluated from CBCT scans. The minimum and maximum distances of any part of the right- and left-side canines to three anatomic reference planes were measured to assess the adequate size and position of a cylindrical image volume.ResultsA cylinder sized 39.0 (diameter)×33.2 (height) mm, with its top situated 13.8 mm above the hard palate, its medial edge 8.4 mm across the midline, and anterior edge 2.5 mm in front of the labial surface of maxillary central incisors fitted all the analyzed canines.ConclusionsIn this sample, the FOV required for imaging maxillary impacted canines was smaller than the smallest FOV offered by common CBCT devices. We encourage development of indication-specific CBCT imaging programs and aids to facilitate optimum patient positioning.Clinical relevanceAn impacted maxillary canine is a common dental problem and a frequent indication for 3D imaging particularly in growing individuals. This article focuses on the optimization of CBCT of impacted canines. Our recommendation of a reduced FOV promotes radiation safety.
Highlights
Cone-beam computed tomography (CBCT) is a three- dimensional (3D) radiographic method used in dentistry mainly for imaging of teeth, jaws, and mid-facial bony structures [1]
To locate the impacted canines in an X-Y-Z-coordinate defined by three anatomical reference planes that were placed in the 3D view at right angles in relation to each other: (a) Midsagittal plane; set along the intermaxillary suture (IS) from the anterior nasal spine (ANS) to the posterior nasal spine (PNS)
Analysis of the 71 cone-beam computed tomography (CBCT) scans showed that the planned measurements could not be performed on 28 because there were artifacts (N = 3), the canine fell partly outside the FOV (N = 2), or the anatomic structures needed to construct the 3D coordinate—labial surfaces of maxillary incisors in the majority of cases—were not visible in the FOV (N = 23)
Summary
Cone-beam computed tomography (CBCT) is a three- dimensional (3D) radiographic method used in dentistry mainly for imaging of teeth, jaws, and mid-facial bony structures [1]. CBCTs are applied for example for orthodontic, endodontic, and surgical reasons, for assessment of periapical diseases, bone pathologies, dento-alveolar and facial trauma, and temporomandibular joints [1]. Localization of maxillary unerupted or impacted anterior teeth forms a common indication for CBCT in adolescents [2, 3]. Compared to two-dimensional (2D) imaging methods, CBCT is more precise and accurate in localizing unerupted maxillary canines and detection of root resorption in adjacent teeth [4,5,6,7], but it exposes the patient to a higher radiation dose. According to Wriedt et al, CBCT with a small field-of-view (FOV) would be justified when canines incline more than 30° from a vertical position, and there is suspicion of resorption of adjacent teeth,
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