Localization Of Impacted Canines Research Articles

Determination of the position of impacted maxillary canine – A panoramic radiographic study

Maxillary canines are one of the most common impacted teeth. The objective in localization of an impacted canine is to be able to decide such a radiographic technique which has minimal radiation dose, cost and minimum superimpositions. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines, when compared to cone-beam computed tomography.OPG and CBCT images of 100 maxillary impacted canines were included in the study irrespective of site. Each OPG was evaluated for vertical angulation and the data obtained was tabulated and subjected to statistical analysis.In the present study, the female to male ratio was 2.57:1, with a slightly higher prevalence of impacted maxillary canines on left side. The results of the present study show a 100% concordance between OPG and CBCT for palatal and buccal impactions, and 91% for mid-alveolus impactions.Based on the results of the present study, it may be concluded that panoramic radiographs are useful for predicting the location of impacted maxillary canines against the confirmatory radiographic modality like CBCT.

Estimating the 3-D location of impacted maxillary canines: A CBCT-based analysis of severity of impaction.

The objective of the study was to quantify the 3-D location of impacted canines by measuring their linear and angular deviations in relation to adjacent structures and further evaluate impaction severity. CBCT images of 314 impacted canines were analysed in the sagittal, coronal and axial planes. Linear and angular measurements were recorded. Canine inclination was identified in coronal and sagittal planes. An evaluation system was constructed for analysis. Upright canine was considered as the appropriate position for fully erupted maxillary canine. Outcomes were compared between right and left sides and by gender. For categorical variables, chi-square tests were used while Mann-Whitney U test was used for continuous variables. Regression models were used to measure severity. Impactions were greater in females (119/207; 57.5%). No significant differences between unilateral (100/207; 49.3%) and bilateral (107/207; 51.7%) (P> 0.05). Out of 314 impactions, 105 (33.4%) were mild, 118 (37.58%) moderate and 91 (28.98%) severe. Severe impactions were primarily buccal (44/ 91; 48.3%), in the occlusal ½ of the adjacent incisor root (38/ 91, 41.7%), mesial to the distal border of central incisor (47/91, 51.6%), with sagittal angle value + >45 ̊ (46/ 91, 50.5%) and mesial tip + >30 ̊ (86/ 91, 94.5%). Severely impacted canines had their crowns buccal, closer to occlusal plane and mesial to the distal border of the central incisor with greater than 45-degree buccal inclination and greater than 30-degree mesial tip. The sagittal angle can have a significant impact on the severity of impaction. A new classification system was proposed to quantify severity.

Orthodontic traction of impacted maxillary canines using segmented arch mechanics.

ABSTRACTThe principles of orthodontic mechanics strongly influence the success of impacted canine traction. The present study discusses the main imaging exams used for diagnosis and localization of impacted canines, the possible associated etiological factors and the most indicated mechanical solutions.

Importância da tomografia computadorizada de feixe cônico na avaliação de canino incluso na maxila

Objetivo: realizar um levantamento da literatura acerca da importância da tomografia computadorizada de feixe cônico (TCFC) no diagnóstico de caninos impactados na região maxilar. Material e Métodos: foram pesquisados artigos entre 2001 e 2016 e 36 artigos foram selecionados para a revisão de literatura. Resultados: a TCFC quando comparada aos exames radiográficos apresenta maior nível de confiabilidade para elaboração do plano de tratamento, permite identificar de forma mais precisa a real localização e inclinação do canino impactado e a presença de reabsorções nos dentes adjacentes. Conclusão: a TCFC consegue demonstrar com precisão a localização do canino incluso, estruturas adjacentes afetadas e achados incidentais, com destaque para o grau de reabsorção de incisivos centrais e laterais, sendo, portanto, superior aos exames radiográficos.

The Relationship between Dental Follicle Width and Maxillary Impacted Canines' Descriptive and Resorptive Features Using Cone-Beam Computed Tomography.

Objectives To assess the relationship between dental follicle width and maxillary impacted canines' descriptive and resorptive features with three-dimensional (3D) cone-beam computed tomography (CBCT). Methods The study comprised 102 patients with cone-beam computed tomography 3D images and a total of 140 impacted canines. The association between maxillary impacted canine dental follicle width and the variables of gender, impaction side (right and left), localization of impacted canine (buccal, central, and palatal), and resorption of the adjacent laterals was compared. Measurements were analyzed with Student's t-test, Kruskal-Wallis test, and Mann–Whitney U statistical test. Results According to gender, no statistically significant differences were found in the follicle size of the maxillary impacted canine between males and females (p > 0.05). Widths of the follicles were determined for the right and left impaction sides, and no statistically significant relation was found (p > 0.05). There were statistically significant differences between root resorption degrees of lateral incisors and maxillary impacted canine follicle width (p < 0.05). Statistically significant higher follicle width values were present in degree 2 (mild) resorption than in degree 1 (no) and degree 3 (moderate) resorption samples (p < 0.05). Conclusions No significant correlation was found between follicle width and the variables of gender, impaction side, and localization of maxillary impacted canines. Our study could not confirm that increased dental follicle width of the maxillary impacted canines exhibited more resorption risk for the adjacent lateral incisors.

Cone beam computed tomography: A newer avenue in orthodontic diagnosis and treatment planning

Cone beam computed tomography (CBCT)-three-dimensional (3D) imaging technique has shown tremendous progress since its introduction in dentistry and reformed the efficiency and effectiveness of orthodontic care. There has been a great revolution from its use as a predominantly diagnostic tool to an imaging method now used for predicting treatment outcomes and planning treatment. The conventional imaging techniques are basically two-dimensional (2D) representations of 3D objects and hence, they have many limitations. Malocclusion results from discrepancies in three planes of space and hence, 2D imaging cannot be used to achieve ideal imaging goals in orthodontics. It is an excellent tool for diagnosis, treatment planning, patient management and education, improved treatment outcome, and patient satisfaction. A cone beam examination is recommended in the detection of assessing shape and growth of mandible, localization of impacted canines, evaluation of root resorption repair, for the placement of temporary anchorage device, airway analysis in growing patients with maxillary constriction treated with rapid palatal expansion, etc, This article provides a comprehensive and current review of key studies on the applications of CBCT in orthodontic diagnosis and treatment planning.

Evaluation of radiographic techniques for localization of impacted maxillary canines

Maxillary canines are the most frequently impacted teeth after the third molars. The study was performed on 50 impacted maxillary canines. The selected patients were examined systematically and radiological examinations were carried out, which included two periapical, a cross-sectional maxillary occlusal radiograph, and a panoramic radiograph for each impacted canine. The two periapical radiographs were taken using the tube shift technique with a horizontal tube shift. Correct prediction of the labiolingual position of canine impaction is possible by using the same-side-lingual opposite-side-buccal (SLOB) technique. Therefore the results of this technique were used as gold standard in our study. Out of 50 impacted canines, 17 (34 %) were located bucally, 32 (64 %) palatally, and 1 (2 %) in the arch. In all, 40.7 % and 26.1 % of the impacted maxillary canines were located buccally in males and females, respectively. When compared with the results of the SLOB technique, intraoral periapical (IOPA) and occlusal (vertical and horizontal angulation) radiographs, IOPA radiographs and orthopantomograms (OPGs), and occlusal radiographs and OPGs showed statistically significant results. Although OPG also showed statistically significant results, it was a less reliable method. OPG used with occlusal radiographs yielded the most reliable results. Conventional radiography has remained the technique of choice for localization of impacted canines owing to its wide availability, low cost, and less radiation exposure when compared with other advanced modalities such as computed tomography and cone beam computed tomography.

Three-dimensional localization of impacted canines and root resorption assessment using cone beam computed tomography.

The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted canines in Tongji Hospital were examined. The images of CBCT scans were obtained from KaVo 3D exam vision. Angular and linear measurements of the cusp tip and root apex according to the three planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the maxillary and mandibular canines were obtained. Using this technique the operators could envision the location of the impacted canine according to the three clinical planes. Adjacent teeth root resorption of 28.26 % was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption was found in our samples. Accurate and reliable localization of the impacted canines could be obtained from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients with impacted canines.

Comparison of axial and sagittal views for angulation, cuspal tip distance, and alveolus width in maxillary impacted canines using CBCT

Introduction: Three-dimensional (3D) cone-beam computed imaging allows localization of impacted canines, using spatial relationships with excellent tissue contrast. The aim of this study was to compare different views to assess exact localization of impacted maxillary canine using Kodak 9000 (France). Materials and Methods: In this study, 24 consecutive subjects with seven bilateral (considered as two samples) and 17 unilateral impacted maxillary canines were selected and subjected to cone-beam computed tomography (CBCT); axial and sagittal views were captured to localize the exact position of the impacted canine to the occlusal plane and its relation with adjacent incisors. Results: Mean angulation of 37.57° and 40.27° for axial (horizontal) and sagittal (vertical) views, respectively. A correlation was found between the proximity of the impacted canine to the incisors and their resorption (c 2 : 19.584). Cuspal tip distance was higher in sagittal view than in the axial view ( P Conclusion: Depending upon the type of impaction both sagittal and axial views showed significant variation with axial view having predominant values. Therefore, CBCT images can allow the operator to assess the direction of impacted canine, amount of surrounding alveolus bone, local anatomic considerations, resorption, and condition of adjacent teeth; thereby, improving quality of orthodontic treatment planning and as well as surgical approach.

Cone beam CT와 파노라마방사선사진을 이용한 매복 상악 견치의 3차원적 분석

견치의 맹출은 영구치열의 이행에 중요하다. 견치 매복의 원인으로 유치의 조기 상실 또는 만기 잔존, 신생물 등이 있으며 측절치 이상이 상악 견치 매복을 야기할 수 있다. 치료되지 않은 매복 견치는 부정교합, 낭종 등을 야기하고 교정치료를 복잡하게 한다. 이 연구의 목적은 매복된 상악 견치의 위치를 조사하여 치료 및 합병증과의 관계를 규명하는 것이다. 상악 견치 매복으로 진단된 89명의 파노라마사진과 전산화단층영상을 사용하여 견치의 위치를 평가하였다. 시행된 치료와 합병증과의 상관관계에 대해 조사하였다. 가장 흔한 매복 위치는 치열궁 영역이었고 협측과 구개측 순이었다. 교정적 견인이 가장 빈번히 선택되었으며 합병증으로는 인접치를 변위시키는 경우가 가장 흔했다. 협측에 매복 시 변위를 일으키는 경향이 높았고, 협측에 매복될수록 교정적 견인이 덜 시행되었다. 중절치 근심에 매복 시 치근 흡수를 일으키는 경향이 더 높았다. 그러므로 상악 견치에 대한 검진을 통해 조기 진단과 적절한 치료의 시행이 필요하다. Normal eruption of the canine is important for the transition to the permanent dentition. Etiologies, including premature loss or delayed retention of deciduous teeth, neoplasm and abnormality of lateral incisor can cause impaction of the maxillary canine. Untreated canine impaction can result in malocclusion, cyst formation and obstacles in orthodontic treatment. The aim of this study is to evaluate location of the impacted maxillary canine and to identify correlation between location and management of the impaction including complications. Using panoramic radiographs and CBCT scan, images of 89 children diagnosed with impaction of the maxillary canine, location of impacted canines was evaluated. The choice of treatment and complications were investigated to identify correlation. Results show that the most commonly impacted location of the maxillary canine was in the mid-alveolar area, followed by buccal side and palatal side. Orthodontic traction was selected more frequently than the other treatments. As complications, displacement of adjacent tooth was occurred most frequently. Buccally impacted canines showed increased tendency towards displacement. The more buccally the canine was impacted, the less orthodontic traction was chosen as the treatment. The canine impacted mesially to the central incisor showed increased tendency to occur root resorption. Therefore, early diagnosis by periodic examination, appropriate treatment and intervention is required.

Impacted maxillary canines and root resorptions of neighbouring teeth: a radiographic analysis using cone-beam computed tomography

The study analyses the location of impacted maxillary canines and factors influencing root resorptions of adjacent teeth using cone-beam computed tomography (CBCT). In addition, the interrater reliability between observers of two different dental specialties for radiographic parameters will be evaluated. CBCT images of patients who were referred for radiographic localization of impacted maxillary canines and/or suspicion of root resorptions of adjacent teeth were included. The study analysed the exact three-dimensional location of the impacted canines in the anterior maxilla, frequency and extent of root resorptions, and potential influencing factors. To assess interrater agreement, Cohen's correlation parameters were calculated. This study comprises 113 patients with CBCT scans, and 134 impacted canines were analysed retrospectively. In the patients evaluated, 69 impacted canines were located palatally (51.49 per cent), 41 labially (30.60 per cent), and 24 (17.91 per cent) in the middle of the alveolar process. Root resorptions were found in 34 lateral incisors (25.37 per cent), 7 central incisors (5.22 per cent), 6 first premolars (4.48 per cent), and 1 second premolar (0.75 per cent). There was a significant correlation between root resorptions on adjacent teeth and localization of the impacted canine in relation to the bone, as well as vertical localization of the canine. Interrater agreement showed values of 0.546-0.877. CBCT provides accurate information about location of the impacted canine and prevalence and degree of root resorption of neighbouring teeth with high interrater correlation. This information is of great importance for surgeons and orthodontists for accurate diagnostics and interdisciplinary treatment planning.

Transposition of a maxillary canine and a lateral incisor and use of cone-beam computed tomography for treatment planning

This report describes the orthodontic treatment of a 12-year-old girl with transposition of the maxillary left canine and the lateral incisor. Cone-beam computed tomography was used during treatment planning. The transposed tooth positions were corrected with an unconventional orthodontic approach. Treatment alternatives and their clinical concerns are presented.

A novel 3D classification system for canine impactions—the KPG index

3D cone beam imaging allows localization of impacted canines, using spatial relationships, with excellent tissue contrast. The aim of this project was to assess the degree of difficulty for the treatment of impacted canines, based on the 3D information provided by cone beam imaging. 3D cone beam images taken from subjects with impacted canines were obtained from a private practice and school setting. A novel measuring scale was devised, based on three different viewpoints, in order to grade the difficulty of impaction and the potential efficacy of treatment. Depending on its anatomical location, the cusp tip and the root tip are each given a number 0-5 in three dimensions taken from a pretreatment image. The sum of the cusp tip and root tip scores in the three views dictated our anticipated difficulty of treatment. A novel method of analysing impactions using cone beam imaging was proposed. This method utilizes the entire three views of a CBCT image.

Localization of impacted maxillary canines and observation of adjacent incisor resorption with cone-beam computed tomography

The aim of this study was to investigate with cone-beam computed tomography (CBCT) the locations of impacted maxillary canines and resorption of neighboring incisors. Two hundred ten impacted maxillary canines were analyzed using CBCT images. The locations of the impacted canines were assessed and angular and linear measurements were taken using NewTom proprietary software. In addition, root resorption of neighboring incisors was investigated. Among these impactions, 45.2% were impacted buccal-labially, 40.5% were impacted palatally, and 14.3% in the midalveolus. The locations varied: mesial-labial impaction (n = 67), mesial-palatal impaction (n = 74), in situ impaction (n = 31), distal impaction (n = 12), horizontal impaction (n = 18), and inverted impaction (n = 8). Quantitive measurements further depicted these variations. Root resorption was present in 27.2% of lateral and 23.4% of central incisors, and 94.3% of these resorptions occurred where the impacted canines were in close contact with the incisors. The location of impacted maxillary canines varies greatly in 3 planes, and the resorption of neighboring permanent incisors is common.

Three-dimensional localization of maxillary canines with cone-beam computed tomography

Precise 3-dimensional (3D) localization of impacted canines is central to their clinical management. Recently introduced dental 3D volumetric imaging systems make precise localization possible. The purpose of this study was to describe the spatial relationship of impacted canines by using images obtained with the NewTom QR-DVT 9000 (QR Srl, Verona, Italy). Unilaterally and bilaterally impacted canines (n = 27) from 19 consecutive patients (15 female, 4 male) were evaluated on images taken with the NewTom QR-DVT 9000. The spatial relationships of the impacted canines relative to adjacent structures and incisor resorption were assessed with 3D visualization software. Most (92.6%) of the 27 impactions were palatal. Incisor resorption adjacent to the impacted canine was present in 66.7% of the lateral incisors and 11.1% of the central incisors. Follicle size did not play a major role in influencing impacted canine position. The alveolus was narrower at the impacted canine side compared with the erupted canine side; however, the width of the alveolus on the impacted canine side is independent of the deciduous canines. A correlation was found between the proximity of the impacted canine to the incisors and their resorption. There was no common location where eruption was arrested, and great variation in the inclination of the impacted canine was found. 3D volumetric imaging of impacted canines can show the following: presence or absence of the canine, size of the follicle, inclination of the long axis of the tooth, relative buccal and palatal positions, amount of the bone covering the tooth, 3D proximity and resorption of roots of adjacent teeth, condition of adjacent teeth, local anatomic considerations, and overall stage of dental development. In short, 3D imaging is clearly advantageous in the management of impacted canines.

Localization of impacted canines with Status-X radiography

There are, at present, a number of clinical and radiologic methods available to establish the buccopalatal relationship of an impacted maxillary canine. A new method, employing the Status-X x-ray machine, can now be used. This technique makes use of the fact that the anode of the Status-X machine is considered to have an almost point source of x-radiation. Applying the laws of central projection, an object closer to the focal point will produce a larger image on a film than that produced by an object of equal size but farther away from the focal point. In a recent series of twenty-eight canine transplant procedures, this method was used with great success to establish, preoperatively, the position of the impacted canines.