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3D Assessment of Orthodontic Treatment Difficulty of Maxillary Impacted Canine Using KPG Index and Qualitative Bone
Kharman O Mahmood1, Zana Q Omer2
1Department of Orthodontics, College of Dentistry, Hawler Medical University, Erbil, Iraq, Phone: +964 750 686 8244, e-mail: kharman.mahmood@den.hmu.edu.krd, Orcid: https://orcid.org/0009-0003-2897-2696.
Aim:
This study aimed to evaluate the treatment difficulty of impacted maxillary canines by using the KPG index and qualitative measurement of the surrounding alveolar bone based on Hounsfield Unit (HU).
Materials And Methods:
A retrospective cross-sectional analysis was conducted on 115 Cone Beam Computed Tomography (CBCT) scans of patients aged 13 years or older with impacted maxillary canines. The KPG index was used to assess spatial position in three planes. Bone density was measured on buccal, palatal, mesial, and distal surfaces at cervical, middle, and apical root levels. Data were analyzed using SPSS v26, with significance set at p < 0.05.
Results:
Most impactions were palatal (74.78%), unilateral (58.26%), and more frequent in females (69.6%) than males. According to the KPG index, 49.6% were classified as "Difficult," followed by "Moderate" (33.9%). Bone density was highest at the apical root third and increased with age, though no significant gender or impaction-type differences were observed. KPG scores and bone density values showed no significant correlation.
Conclusion:
Most impacted maxillary canines were classified as "difficult" based on the KPG index. Bone density was highest apically and increased with age, but showed no correlation with KPG scores, highlighting the need for independent evaluation of both factors in treatment planning.
Clinical Significance:
Integrating the 3D-based KPG index with bone density measurements enables earlier and more accurate prediction of treatment difficulty in impacted maxillary canines, leading to better treatment planning and improved patient outcomes. How to cite this article: Mahmood KO, Omer ZQ. 3D Assessment of Orthodontic Treatment Difficulty of Maxillary Impacted Canine Using KPG Index and Qualitative Bone Measurement: A Retrospective Study. J Contemp Dent Pract 2025;26(9):836-845.
