Root Resorption Of Lateral Incisors Research Articles

Root Regeneration with Photobiomodulation of an Upper Lateral Incisor Associated with Root Resorption Due to an Impacted Maxillary Canine: A Case Report.

Objective: To present a case report of maxillary lateral incisor root regeneration after severe root resorption, treated with photobiomodulation (PBM). Background: Impacted maxillary canines often come with the risk of maxillary lateral incisor root resorption, which is widely recognized as the predominant adverse effect in these situations. This progressive process of root resorption is currently irreversible, with no known way to reverse it. Materials and methods: A male patient was 14 years old. Radiographically it was observed that canine 23 is impacting against the root of 22 producing signs of root resorption and having a less than 1:1 crown-to-root ratio with mobility grade 1. From the beginning of the treatment, PBM-assisted orthodontics was proposed. To address the patient's dental concerns, the treatment plan outlined the extraction of the deciduous upper left canine tooth leaving the lateral as long as possible in the mouth. During each appointment, PBM was applied with a diode laser. The wavelength was 810 nm, Ap = 0.2 W, 4.4 J, 22 sec every 21 days, 13 applications in total (57.2J), with a 400 μm inactive surgical tip, in a scanning movement, 1 mm from the mucosa while moving following the vestibular surface of the upper left lateral and canine roots. Results: After 12 months, the 22 had root neoformation and complete closure of the apex with vitality. Conclusions: PBM with an 810 nm diode laser in this clinical case promoted root regeneration of an upper lateral incisor, with severe root resorption, owing to an impacted maxillary canine while still vital.

Long-term follow-up after the treatment of impacted canines in the maxilla causing severe root resorption of the lateral incisors: two case reports

BackgroundRoot resorption of adjacent teeth due to impacted canines is common, and orthodontic treatment often leads to secondary resorption or even loss of adjacent roots. Clinical reports of long-term stability after treatment are rare.Case presentationThis study reports two cases of maxillary impacted canines resulting in severe root resorption of the adjacent lateral incisors. Surgical exposure, orthodontic retraction, and alignment of the impacted canines were successful in both cases, and the resorbed lateral incisors were stable with no significant loosening and normal pulp vitality after treatment and at the 5- and 10-year follow-up appointments.ConclusionsLight orthodontic force may be used to move adjacent teeth with root resorption due to tooth obstruction. The path and direction in which the teeth are moved must be specifically designed so that the adjacent roots are not resorbed and so long-term stability can be achieved.

Influence of alveolar bone thickness and bucco-palatal inclination on root resorption of lateral incisors in unilateral maxillary impacted canines: a retrospective observational study

BackgroundThis study aimed to investigate the potential associations between alveolar bone thickness, bucco-palatal inclination of maxillary lateral incisors, and lateral incisor root resorption in patients with unilateral maxillary impacted canines (UMICs).MethodsA total of three hundred and five subjects (120 males, 185 females; mean age, 16.39 years; standard deviation, 4.04) with UMICs were included. Canine position and root resorption were assessed using CBCT. UMICs were divided into palatal, buccal and mid-alveolus groups (PICs, BICs and MAICs), with 117, 137 and 51 subjects, respectively. Alveolar bone thickness and bucco-palatal inclination of lateral incisors were measured using the Dolphin software.ResultsThe prevalence of lateral incisor root resorption was significantly lower in the BICs (13.9%) than MAICs (29.4%) and PICs (29.1%). Alveolar bone thickness of the apical area was smaller in UMICs with lateral incisor root resorption than no resorption in both PICs (8.33 ± 1.64 vs 10.53 ± 2.55 mm) and BICs (8.94 ± 1.85 vs 10.76 ± 2.28 mm). Furthermore, lateral incisors on the impacted side were more buccally inclined in PICs with lateral incisor root resorption than no resorption, while in both BICs and MAICs, there was no statistical difference between lateral incisor root resorption than no resorption. Moreover, alveolar bone thickness of the apical area, rather than bucco-palatal inclination of lateral incisors, was significantly correlated with lateral incisor root resorption both in PICs and BICs.ConclusionsLateral incisor root resorption is less common in BICs. Thinner alveolar bone thickness at the apical area of lateral incisors can be considered as a potential risk factor for lateral incisor root resorption in UMICs.

Everybody gets an expander

Seemingly every preadolescent patient that presents for an orthodontic consultation is prescribed rapid maxillary expansion (RME) treatment. Parents are forewarned of premolar extractions, lateral incisor root resorption from ectopic canines, or obstructive sleep apnea if they delay treatment. Are we exaggerating the need for Phase I RME in pursuit of two-phase treatment and increased revenue? Let's take a closer look at the history, trends, expectations, and proper timing of RME, with an emphasis on Phase I treatment.

3-D assessment of skeletal and dentoalveolar bilateral dimensions in unilateral impacted palatal canine cases - A CBCT study.

The aim of this study was to compare skeletal and dentoalveolar dimensions in subjects with maxillary unilateral impacted palatal canines versus the unaffected contralateral side using CBCT. Skeletal and dentoalveolar variables (Anterior alveolar ridge height, Anterior dentoalveolar height , nasal cavity width, basal nasal width, Lateral angulation of long axis of the incisors and canines with respect to the nasal horizontal plane, premolar to median raphe width, dimensions of lateral incisor and canine, root resorption of lateral incisors, crown-root angulation of lateral incisor, and sector classification of canine) were compared between the impacted and the contralateral sides. As the data had normal distribution, means were compared using students t test. The significance was set at p<0.05. The root resorption in lateral incisor was compared using Chi square test. Lateral angulation of long axis of canines, nasal cavity width, basal lateral width, and premolar to median raphe width were found to be significantly different. Maximum number fell in sector 4 (n = 23, 38.3%) in sector classification. Root resorption of lateral incisor on impacted side was insignificant. Skeletal and dento-alveolar dimensions vary between the impacted and non-impacted sides in unilateral palatal canine impaction cases. Canines on the impacted side were more mesially angulated compared to the non-impacted side. The nasal cavity width, basal lateral width and premolar to median raphe width were significantly less on the impacted side compared to the non- impacted side. Key words:Impacted canine, CBCT, skeletal dimensions, diagnosis, orthodontic treatment.

Volumetric Evaluation of Maxillary Lateral Incisor Root Resorption due to Positional Variations of Impacted Canine.

Introduction The purpose of this study was to investigate the relationship of the volume of lateral incisor resorption and impacted canine features. Materials and Methods This study consisted of CBCT images of 47 samples with unilateral impacted maxillary canine (13 males and 34 females). The volume of lateral incisors in impacted side and nonimpacted side was calculated with the Mimics 10.01 software. Canine and lateral incisor angulations were measured in panoramic reformatted images. The canine cusp tip distance from midpalatal suture was measured in axial cross-section images. Results The difference between two sides volume was considered as the mean volume of resorption (MVR) that was statistically significant (P < 0.001). MVR was not statistically significant between two sexes (P=0.95), in buccopalatal and mesiodistal positions of impacted canine, and in different angulations or distances of the impacted canine to midline (P > 0.05). The concurrent effect of the canine distance to the midline and the angle of the canine with the lateral incisor on the MVR were statistically significant (P=0.049). Conclusion The maximum rate of lateral root resorption is when the distance from the canine to the midline is less than 5 mm and the angle of the canine to the lateral incisor is 30–60 degrees.

Lateral Incisor Root Resorption: A Consequence of Ectopic Maxillary Canine Teeth

Root resorption of permanent teeth is a recognized complication of ectopic maxillary permanent canines. This type of resorption is sometimes missed and can be diagnosed at the late presentation stage. Treatment of external resorption is complex and can require extraction of the affected tooth. This review provides an insight into the current evidence and guidance related to the interceptive treatment of displaced permanent maxillary canines to minimize the risk of resorption of adjacent teeth. Supported by two clinical cases, it looks into treatment options and long-term management of lateral incisors with external root resorption of varying severities. CPD/Clinical Relevance: Primary care practitioners are best placed to recognize displaced maxillary permanent canines in a timely manner, and so, root resorption of adjacent teeth may be prevented.

The diagnostic value of orthopantomograms in detecting resorption of lateral incisors associated with ectopic canines: a CBCT study.

To examine the diagnostic value of orthopantomograms (OPG) in the identification of root resorption of lateral incisors, secondary to an impacted canine, as confirmed by a cone-beam computed tomography (CBCT) scan. Retrospective observational cohort study. South Wales secondary care setting: Royal Gwent Hospital, Newport and Nevill Hall Hospital, Abergavenny. A total of 40 consecutive patients with impacted canines between January 2018 and December 2019 were selected. For each patient, one consultant orthodontist examined the OPG in isolation to detect the presence and extent of resorption of lateral incisors. The CBCT report was then studied to confirm the presence and extent of pathology. Sensitivity, specificity, accuracy, positive predictive values and negative predictive values were calculated. In total, 19 maxillary right canines, 18 maxillary left canines, one mandibular right canine and two mandibular left canines were examined. Impactions were more prevalent in the maxilla (92.5%) with higher predilection towards female patients (65%). There was higher prevalence of root resorption in the maxillary right quadrant (57.1%), in concordance with other studies. OPGs were found to have a sensitivity of 81.0% and a specificity of 10.5%, with an accuracy value of 47.5%. Positive and negative predictive values were found to be 50.0% and 33.3%, respectively. The extent of root resorption was incorrectly estimated from the OPG in 84% of cases. Correct estimation occurred in 16% of cases, with overestimation and underestimation occurring in equal proportion (42%). This study demonstrates the limitations of plain film radiographs and the merits of using CBCT in the accurate diagnosis of resorption of lateral incisors with an associated impacted canine. It also gives an indication into the location prevalence of resorption in a small cohort of patients. This preliminary study establishes the basis for future, larger-scale studies where outcomes can be generalisable at a population level.

Incidence of lateral incisor root resorption associated with impacted maxillary canines

Abstract Introduction The aim of this study was to determine the incidence of lateral incisor root resorption associated with impacted maxillary canines and determine predisposing factors that may be used to predict its occurrence. Methods Cone beam computerised tomographic images of 133 patients presenting with 186 impacted canines were examined for lateral incisor root resorption. A control sample consisted of 30 lateral incisors on the side of the non-impacted canine. The studied canine-associated variables were gender, type of impaction, location of the canine both meso-distally and vertically and the long axis angulation to the midline. Axial images were primarily used to diagnose resorption. Results The estimated percentage of lateral root resorption in the sample was 17% (range 11.8– 23.9%) confirmed at a 95% confidence interval. A significant association was observed between the level of overlap of the canine across the lateral incisor, measured in sectors, and the probability of lateral incisor root resorption. The probability approximately doubled for each additional sector of canine overlap. No other significant association was noted related to all the other variables examined. Conclusions The incidence of lateral incisor root resorption associated with impacted maxillary canines was lower in the present study compared with many previous reports. However, resorption remains a common clinical finding. In order to screen for lateral incisor resorption, it is recommended that a cone beam image be prescribed when there is a mesial overlap of an impacted canine across the lateral incisor midline.

The assesment of pattern of maxillary canine impaction in the Ardabil city

Background &amp; Objective: Impacted teeth are one of the most common reasons for visit- ing dentists and maxillofacial surgeons. During clinical and radiographic examinations and evalu- ations, the dentist sometimes realizes that the patient’s problem is due to the impaction of one or more teeth. Therefore, it is necessary for every dentist to make the necessary and correct decision for the treatment of such teeth. One of the best ways to diagnose impacted teeth is first of all the absence of that tooth in the desired location and clinical evaluation of the patient and secondly to check the radiographic view of the desired area. Impacted teeth can be the source of many prob- lems for various reasons, so in most cases, their extraction is recommended. Knowing how to place the impacted tooth and determining its type and other characteristics of the impaction can help the dentist in choosing the appropriate treatment-surgical method and also prevent complications during surgery. Proper and timely diagnosis of impaction as well as determining its position (buc- cal-palatal-intermediate) in the jawbone can reduce damage to adjacent structures and also affect the treatment plan. Because accurate detection of impacted tooth positions is possible with radiog- raphy, the most accurate radiograph to examine the impacted tooth is cbct images. Therefore, due to possible occlusion injuries and the effect of occlusion pattern on the treatment of these teeth, it is important to study the types of impaction patterns. Therefore, this study was presented with the aim of investigating the impaction pattern of maxillary canine teeth in Ardabil with cbct archive.&#x0D; Materials and Methods: In this descriptive cross-sectional study, CBCT images of 239 patients who met the inclusion criteria were evaluated. Due to the lack of statistics, due to the lack of statistics of maxillary impacted canine teeth in Ardabil, the counting method was used for sampling and stereotypes were identified as maxillary impacted canine teeth as the sample size. The obtained data were analyzed in SPSS24 software.&#x0D; Results: Among the impacted canine teeth studied, 63.2% had palatal, 17.5% buccal and 19.3% had intermediate pattern. Also, 11.2% had damage to adjacent structures and 88.8% had no damage to adjacent structures. Among the types of damage to adjacent structures, 46.9% caused root re- sorption of the first premolars, 34.5% caused root canal resorption, and 18.6% had other damage to adjacent structures. Of these, 50.4% had root curvature and 49.6% had no root curvature, of which 12.1% had severe curvature, 38.7% had mild curvature and 49.2% had severe curvature. Also, the average angle of the incised canine to the lateral incisor was 41.7%. 9% of impacted canine teeth had a root resorption of lateral incisors and 9% did not have a root resorption of lateral incisors.&#x0D; Conclusion: Dentists should treat cases such as maxillary latent canine such as: Examine the occlusion pattern, angle to adjacent teeth, damage to adjacent structures, curvature of the incised canine root, and root resorption of adjacent teeth.

Relationship of Angulation of Maxillary Impacted Canines with Maxillary Lateral Incisor Root Resorption

Objective: To assess the relationship of ɑ and s angles of maxillary impacted canines with maxillary lateral incisor root resorption . Material and Methods: For this, 40 patients (between 11 and 45 years) with impacted maxillary canines presenting to a private orthodontic clinic were evaluated.20% of the cases were male and 80% were female. The ɑ and s angles were measured on panoramic radiographs to determine the angulation of impacted canine. CBCT scans had been taken by ProMax 3D CBCT system were used to examine lateral root reorption. The relationship between the size of ɑ and s angles of impacted maxillary canines and root resorption in the adjacent maxillary lateral incisor was analyzed using SPSS version 22. Results: The mean size of ɑ and s angles had no significant correlation with the presence/absence, location, or severity of root resorption in the adjacent lateral incisor or the buccolingual position of impacted canine. The ɑ and s angles in impacted maxillary canines cannot be used to determine the incidence or severity of root resorption in the adjacent lateral incisor . Conclusion: No significant association between ɑ and s angles and incidence or severity of root resorption in the adjacent lateral incisor was found.

Risk factors for maxillary impacted canine–linked severe lateral incisor root resorption: A cone-beam computed tomography study

Impacted maxillary canine-linked severe lateral incisor root resorption (SIRRc) is rare, but it greatly influences the survival of the affected teeth. Our study was designed to investigate the risk factors for SIRRc. Eighty-two patients with SIRRc and 81 patients with impacted maxillary canines but without SIRRc were included and evaluated by cone-beam computed tomography in software programs by 1 examiner (H.W.). Age, sex, positions, and dental follicles and angular inclinations of impacted canines were measured in this study. Binary logistic regression was used to analyze the risk factors for SIRRc. SIRRc was highly related to sex, vertical and mesiodistal position, dental follicles sizes of canines, and intersection angles in 3dimensions.The regression analysis showed female sex, dental follicles between 1mm and 3mm, mesial third and apical third position, vertical angle smaller than 30°, and the relative angle between 30° and 60° were significant risk factors for SIRRc. Early diagnosis and treatment for SIRRc are imperative, especially in Asian patients that are female with apically and mesially positioned canines as well as wider dental follicles. Vertical angles and relative angles of impacted canines should also be noticed.

Evaluation of impacted maxillary canine position using panoramic radiography and cone beam computed tomography

IntroductionLocalization of impacted maxillary canine (IMC) position is essential in orthodontic treatment for accurate orthodontic treatment as well as prognosis. ObjectivesThis study aimed to: 1- investigate the relationship between the locations of IMC in panoramic radiograph (PR) using sectors in relation to their labio-palatal position in cone beam computed tomography (CBCT): 2- report the incisor root resorption in CBCT in relation to its sector location of IMC in PR. Material and MethodsThe study is a retrospective imaging assessment of 60 IMCs in multiple centers in Riyadh, Saudi Arabia. Sector location of IMC was determined on the PR and correlated with each of their labio-palatal positions and resorption of the root of permanent incisors using CBCT. ResultsThere is a significant correlation between sector location and impaction location of IMC. No statistical correlation was found between IMC sector location and lateral incisor root resorption, whereas a significant correlation was found between sector location and central incisor root resorption. ConclusionsFor Sectors I and II, IMC tended to be in either the mid-alveolus or labial location, whereas Sectors III and IV tended to show palatal impaction. Therefore, sector could be a good tool for localization of IMC and to predict the possibility of incisor root resorption.

MAXILLARY CANINE FOLLICULAR SPACE AND LATERAL INCISOR ROOT RESORPTION: A CBCT STUDY

Background It has been shown that the dental follicle is necessary for signaling osteoclasts to induce resorption of bone in the direction of the eruption.1 A dental follicle can also induce resorption of nearby anatomic structures, including adjacent teeth, if there is insufficient space for the tooth to emerge. Objective The objective of this study was to identify patterns of resorption in maxillary lateral incisor roots and investigate a relationship to the width of the follicular space of the adjacent erupting canines. Methods Three hundred and thirty cone beam computed tomography (CBCT) volumes were obtained from an orthodontic practice, and identifying data were removed according to institutional review board guidelines. Each volume was analyzed for the presence of unerupted canines and lateral incisor. Results From the sagittal, the range of follicle sizes was 0.5 to 4.9 mm. From the axial, the range of follicle sizes was 0.5 to 4.9 mm. From the coronal, the range of follicle sizes was 0.5 to 5.4 mm. At a cutoff point of 2.03 mm, there was 76%, and sensitivity was 72%. Discussion The study included 252 canine teeth with enlarged follicular spaces. Fifty-two lateral incisors showed radiographic evidence of resorption, almost always on the distal–palatal aspect of the root. The statistical model predicted that if the follicle has an average size of 2.03 mm or greater, the patient has a higher predisposition of having lateral incisor root resorption on the same side.

Effects of impacted maxillary canines on root resorption of lateral incisors : A cone beam computed tomography study.

The aim of this study was to analyze the amount of root resorption of maxillary lateral incisors by relating the position, location, and angulation of the impacted canine using cone-beam computed tomography (CBCT). The study sample consisted of panoramic and CBCT radiographs of 46 patients with a unilateral impacted canine (16 males and 30 females; mean age: 19.53±6.66 and 19.44±5.77years, respectively). Sector location and canine angulation were measured in panoramics. All tomographs were obtained using CBCT (NewTom 5G, QR, Verona, Italy) and three-dimensional (3D) reconstructions of the maxillary laterals assessed by Mimics 14.01 image analysis software. Upper lateral incisor volume was smaller on the impacted side (401.95±83.69mm3) than on the nonimpacted side (433.54±92.6mm3, P<0.05). There were no significant differences of lateral root resorption volume when comparing the impacted canines being on the labial or palatal sides (P>0.05), but impacted canine angulation was significantly steeper on the labial side (70.85°) than on the palatal side (46.09°, P<0.05). The volume of root resorption of laterals when comparing the various positions of the canine in different sectors or canine angulation in 30o intervals was not statistically significantly different (P>0.05). The impacted canines caused root resorption oflateral incisors. The angulation of the canine was steeper on the labial side thanon the palatal side but root resorption of adjacent laterals was not different. There were no statistically significant differences in the amount of root resorption of the laterals when the canine was evaluated according to localization and angulation.

Pre-surgical treatment planning of maxillary canine impactions using panoramicvscone beam CT imaging

The aim of this prospective study was to compare the impact of using two-dimensional (2D) panoramic radiographs and three-dimensional (3D) cone beam CT for the surgical treatment planning of impacted maxillary canines. This study consisted of 32 subjects (19 females, 13 males) with a mean age of 25 years, referred for surgical intervention of 39 maxillary impacted canines. Initial 2D panoramic radiography was available, and 3D cone beam CT imaging was obtained upon clinical indication. Both 2D and 3D pre-operative radiographic diagnostic sets were subsequently analysed by six observers. Perioperative evaluations were conducted by the treating surgeon. McNemar tests, hierarchical logistic regression and linear mixed models were used to explore the differences in evaluations between imaging modalities. Significantly higher confidence levels were observed for 3D image-based treatment plans than for 2D image-based plans (p < 0.001). The evaluations of canine crown position, contact relationship and lateral incisor root resorption were significantly different between the 2D and 3D images. By contrast, pre- and perioperative evaluations were not significantly different between the two image modalities. Surgical treatment planning of impacted maxillary canines was not significantly different between panoramic and cone beam CT images.

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: A radiographic study

The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment.

Bilateral Impacted Maxillary Canine with Left Lateral Incisor Root Resorption

After the third molars, the maxillary permanent canines are the teeth most frequently impacted. The diagnosis, based on clinical and radiographic examination, is usually made by the general dental practitioner. An ectopic canine, if undiagnosed and untreated, will induce complex complication like root resorption of adjacent tooth or teeth. Periodic examination starting at age 8, including clinical intraoral palpation and selective radiographs, may aid in the early diagnosis of unerupting and potentially impacted permanent canines. When such a diagnosis is apparent, timely interceptive therapy may then be instituted to avoid a situation like impaction and resortion of root of adjacent tooth. This paper presents brief review and orthodontic management of bilaterally; both palatal as well as labilally impacted canines with advanced resorption of adjacent lateral incisor on left side.

Impacted upper canines: examination and treatment proposal based on 3D versus 2D diagnosis

The purpose of this diagnostic cross-over study was to evaluate whether three-dimensional (3D) diagnostics (cone-beam computed tomography, CBCT) was superior to two-dimensional (2D) diagnostics (panoramic X-ray, OPG) in patients with impacted upper canines for assessing their position and the probability of their alignment. Panoramic X-rays, CBCTs, and study casts of 21 patients with a total of 29 impacted maxillary canines were analyzed. Patients with syndromes or tooth aplasias were excluded. A total of 26 dentists of various specialist disciplines rated different parameters, such as canine position and their probability of alignment as well as their relation to and resorption of adjacent teeth. 2D X-rays and study casts were rated first; then 3D images and casts were evaluated at least 2 weeks later. The actual level of displacement was defined by two trained examiners and labeled as the master finding, according to modified criteria established by Ericson and Kurol (1988). In 64% of all patients, canine position was assessed concordantly in 2D and 3D images. 2D assessments were in slight agreement (κ = 0.374), while 3D ratings were in good agreement with the master findings (κ = 0.714). Two-thirds of the canines' apical regions were judged identifiable in 2D and 3D images; more than 1/4 of the canines' apices were not identifiable in 2D images, but were identifiable in 3D images. The diagnosis of lateral incisor root resorption in the CBCT agreed well with the master finding (κ = 0.634), but examiners overlooked slight resorption in 20% of the patients. In 82% of the patients teeth, treatment suggestions (orthodontic alignment or surgical removal) were the same for 2D and 3D images. Canine inclination visible in the panoramic X-rays was the most important factor influencing the treatment proposal. Small volume CBCT may be justified as a supplement to a routine panoramic X-ray in the following cases: when canine inclination in the panoramic X-ray exceeds 30°, when root resorption of adjacent teeth is suspected, and/or when the canine apex is not clearly discernible in the panoramic X-ray, implying dilaceration of the canine root. We intend to validate the results of this study in a clinical trial.

Comparison of two cone beam computed tomographic systems versus panoramic imaging for localization of impacted maxillary canines and detection of root resorption

The diagnostic accuracy for the localization of impacted canines and the detection of canine-induced root resorption of maxillary incisors were compared between conventional radiographic procedures using one two-dimensional (2D) panoramic radiograph with that of two three-dimensional (3D) cone beam computed tomography (CBCT) scans. The clinical records of 60 consecutive patients who had impacted or ectopically erupting maxillary canines were identified from those seeking orthodontic treatment. For each case, two sets of radiographic information were obtained. The study sample was divided into two groups: group A (n = 30) included those for whom a dental pantomograph (DPT) and CBCT obtained with a 3D Accuitomo-XYZ Slice View Tomograph were available and group B (n = 30) who had a DPT and CBCT obtained with a Scanora. The DPT and CBCT images were subsequently analysed by 11 examiners. Statistical analysis included an evaluation of the agreement between observers based on the standard error of the measurement, kappa statistics and coefficient of concordance, as well as an assessment of the differences between 2D and 3D imaging employing Wilcoxon signed rank and McNemar tests. There was a highly significant difference between the 2D and 3D images in the width of the canine crown (P < 0.001) and in canine angulation to the occlusal plane. Moreover, there was a highly significant difference between the DPT and Scanora CBCT images in canine angulation to the midline (P < 0.001). There was also a significant difference between 2D and 3D images with respect to canine location (P = 0.0074 for group A and P = 0.0008 for group B). The presence or absence of root resorption of the lateral incisor was also significantly different in both groups (P = 0.0201 and P < 0.001 for groups A and B, respectively). Detection of central incisor root resorption was significantly different between the Accuitomo and DPT images (P = 0.045). There was also a significant difference in the severity of lateral incisor root resorption between the DPT and CBCT in both groups (P = 0.02). The results of this study suggest that CBCT is more sensitive than conventional radiography for both canine localization and identification of root resorption of adjacent teeth.