Abstract
In recent years Cone Beam Computed Tomography (CBCT) has become a widely accepted radiographic tool for diagnosis, treatment planning and follow-up in dentistry. 3D imaging has improved diagnostic efficiency and the practice of dentistry in a variety of ways; from routine evaluation to complex analysis of unusual pathology and congenital deformities. The technology available today makes dentistry better, easier, and more accurate. The most recognized need for CBCT imaging in orthodontics is that of the impacted canine evaluation. This article reports a patient having impacted right maxillary lateral incisor and canine; which is evaluated by 3D CBCT and was found beneficial particularly in terms of anatomical detail of root resorption and labiolingual relationships of the impacted tooth with the roots of neighboring teeth. Linear and angular measurements on CBCT images were accurate and helped in determining the exact location of the impacted teeth making it convenient for the surgical exposure of impacted teet
Highlights
Mismanagement, failure to diagnose or untreated impacted canines can lead to external resorption of adjacent teeth, especially the lateral incisors, aesthetic problems, malalignment of neighboring teeth, shortened dental arches, and an increase in the occurrence of follicular cyst formation and recurrent infections resulting in irreversible damage that may eventually cause tooth loss.[6,7,8,9]
Cone Beam Computed Tomography (CBCT) technology is based on the use of a cone-shaped X-ray beam that is directed through the patient and the remnant beam is captured on a flat two-dimensional (2D) detector (Scarfe et al, 2006).[11]
Katheria et al found that CBCT provides more information regarding the location of pathology, the presence of root resorption, and treatment planning.[12]
Summary
Maxillary canines are the second most frequently impacted teeth after the third molar, with the prevalence of 1-3%.1-5 Mismanagement, failure to diagnose or untreated impacted canines can lead to external resorption of adjacent teeth, especially the lateral incisors, aesthetic problems, malalignment of neighboring teeth, shortened dental arches, and an increase in the occurrence of follicular cyst formation and recurrent infections resulting in irreversible damage that may eventually cause tooth loss.[6,7,8,9]. Panoramic x-ray revealed impacted upper right lateral incisor and canine (Figure 3A). The radiograph showed erupting third molars on both sides of upper and lower arch along with impacted upper right lateral incisor and canine. Figure 4: 3D CBCT images showing the presence of two supernumerary teeth along with the position of impacted 12 and 13, proximity of impacted teeth with the adjacent teeth (12-upper right lateral, 13-upper right canine) Force added on the exposed teeth to pull the teeth downward for proper alignment of the arch In this case, CBCT was helpful in locating the exact position of the impacted teeth and their relation with the adjacent teeth which helped to access and determine the direction of orthodontic forces.
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