Comparison of Three-Dimensional and Conventional Orthodontic Imaging Modalities for Localization of Impacted Maxillary Canines in Patients With Alveolar Cleft

Abstract

Objective: The purpose of this study was to identify which diagnostic parameters related to impacted maxillary canines can be reliably detected by the conventional orthodontic radiographic modalities and which factors need to be assessed by cone-beam computed tomography (CBCT). Design: In this cross-sectional study, 8 orthodontists evaluated 7 parameters related to the position and anatomy of the impacted canines by means of 2-dimensional (2D) records. After 1 month, the same process was repeated by means of CBCT by the same clinicians. Setting: Qazvin University of Medical Sciences. Patients and Participants: Thirty-two patients with alveolar cleft and impacted maxillary canines who had CBCT scans, lateral cephalograms, and orthopantomographs as pretreatment records. Main Outcome Measure: The diagnostic accuracy of 2D and 3-dimensional (3D) radiographic modalities was compared with each other and also with the gold standard by 3 radiologists. Results: The diagnostic accuracy of 2D and 3D imaging modalities was not significantly different regarding the mesiodistal inclination of the impacted tooth ( P = .09), apex anatomy ( P = .10), and mesiodistal position of the apex ( P = .19). Cone-beam computed tomography had significantly higher diagnostic accuracy than conventional radiographic modalities regarding overlapping the adjacent tooth ( P = .001), labio–palatal and apico–coronal position of the crown tip, and root resorption of the adjacent tooth ( P = .01). Conclusion: The conventional orthodontic radiographic modalities were as accurate as CBCT for determination of impacted canine inclination, apex anatomy, and mesiodistal position of the apex. Cone-beam computed tomography showed higher diagnostic accuracy for other parameters.

Diagnostic accuracy of conventional orthodontic radiographic modalities and cone-beam computed tomography for localization of impacted maxillary canine teeth

“…This finding implies that the lack of a periapical image in the current combination of imaging modalities did not significantly affect the diagnosis. 25 Padisar et al 21 reported a lower interobserver agreement for this parameter in patients with alveolar cleft. This finding could be attributed to the parameters that complicate a correct diagnosis in such patients such as impaired anatomy and superimposition of structures over the cleft site.…”

“…Similarly, another study advised the clinicians not to assess this parameter solely based on 2D images. 21 The lower accuracy of these 2D radiographic modalities for the assessment of this parameter could be attributed to projective displacement and geometric distortion. 23 The interobserver agreement for canine inclination in the current study was similar to the results of a previous study.…”

“…This finding was in line with the current results that revealed superior accuracy of CBCT for this purpose. Some authors reported smaller differences between 2D and 3D radiographic modalities, 21 which may be attributed to the malposition of permanent teeth and supernumeraries in the cleft site that cause radiographic superimposition and complicate the assessments based on 2D images. 11 Accurate determination of this parameter is critical for a favorable prognosis.…”

“…The study was designed according to the concept and methodology of previous studies. 15,20,21 A valid questionnaire was designed to assess the parameters related to the location of impacted canine teeth (Table 1). Eight expert orthodontists were asked to fill out the questionnaire according to the 2D records (panoramic radiographs and lateral cephalograms) of patients.…”

Investigating the effect of depression on clinical symptoms of temporomandibular disorder in young stressful men

“…Different malocclusions have also been a controversial risk factor for TMD (Manfredini et al, 2017 ; Salari et al, 2024 ). The diagnosis is based on clinical examinations, past medical and dental history, and paraclinical data (Daniele Kapos et al, 2020 ; Manfredini et al, 2023 ; Padisar et al, 2020 ).…”