Cone-beam computed tomographic reconstructions in the evaluation of maxillary impacted canines

Area of Science:

• Dentistry
• Orthodontics
• Radiology

Background:

• Radiological interpretation was a key orthodontic skill before cone-beam computed tomography (CBCT).
• Maxillary impacted canines (MICs) present interpretation challenges, especially regarding root resorption, due to their location and surrounding anatomy.
• While CBCT aids MIC diagnosis and treatment planning, the combined use of different reconstruction types has not been evaluated.

Purpose of the Study:

• To assess the diagnostic value of simultaneously using orthogonal and curved/panoramic multiplanar reconstructions from CBCT datasets for MICs.
• To determine if combined reconstructions improve the detection of factors affecting MIC treatment, such as root resorption.

Main Methods:

• Fifteen CBCT datasets of MICs were reconstructed into orthogonal and curved/panoramic multiplanar series.
• Fifteen experienced orthodontists reviewed randomized series of these reconstructions.
• The review focused on identifying MIC position, level, root resorption, ankylosis, cysts, and dilaceration.

Main Results:

• Either reconstruction type alone was sufficient to identify ankylosis and most other features.
• However, accurately determining the presence or absence of root resorption in adjacent teeth required reviewing both orthogonal and curved/panoramic reconstructions.

Conclusions:

• Simultaneous review of orthogonal and curved/panoramic multiplanar reconstructions is necessary for comprehensive evaluation of MICs.
• This combined approach is crucial for detecting root resorption and other critical features adjacent to maxillary impacted canines.