Different diagnostic tools for the localization of impacted maxillary canines: clinical considerations

In this study we evaluated different radiographic exams for the localization of impacted maxillary canines (orthopantomography (OPT), laterolateral and posteroanterior teleradiography, parallax method, laterolateral, occlusal radiography, computerized axial tomography, cone beam CT) highlighting the advantages and disadvantages of each. Four patients with impacted maxillary canines underwent selected radiographic investigations which allowed us to discuss their potential in identifying the position relative to the impacted teeth in the upper jaw. It was not possible to carry out all methods on the same patient as the level of radiation exposure experienced by each patient would too high and therefore unethical. Each method revealed the position of the canine with respect to the adjacent structures and the inclination of the major axis of the impacted tooth with respect to the plane of reference. We then evaluated the ease of use, the dosage of radiation emitted, the significance of the localization of the impacted canine, the immediacy of availability of the information required and the cost of each method. Each technique presented intrinsic advantages and limitations; however CBCT provides elements which escape during traditional radiographic analysis and is therefore indicated in case of impacted teeth or cranio-facial structural anomalies.