Comparative analysis of traditional radiographs and cone-beam computed tomography volumetric images in the diagnosis and treatment planning of maxillary impacted canines

Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif, USA.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics (Impact Factor: 1.44). 05/2010; 137(5):590-7. DOI: 10.1016/j.ajodo.2008.06.035
Source: PubMed

ABSTRACT In this prospective study, we compared differences in the diagnosis and treatment planning of impacted maxillary canines between 2 imaging modalities.
Twenty-five consecutive impacted maxillary canines were identified from the pool of patients seeking orthodontic treatment. The first set of radiographs consisted of traditional 2-dimensional (2D) images including panoramic, occlusal, and 2 periapical radiographs. The second set comprised prints of 3-dimensional (3D) volumetric dentition images obtained from a cone-beam computed tomography (CBCT) scan. Seven faculty member completed a questionnaire for every impacted canine and diagnostic radiographic modality (2D and 3D).
The data show that the judges produced different decisions regarding localization depending on the x-ray method. There were 21% disagreement (or discordance) in the perceived mesiodistal cusp tip position and 16% difference in the perceived labiopalatal position. In the perception of root resorption of adjacent teeth, there was 36% lack of congruence. Twenty-seven percent of the teeth that were planned to be left, recovered, or extracted with the 2D radiographs had different treatment plans when the judges viewed the 3D CBCT images (McNemar test, chi-square, 4.45; P = 0.035). The clinicians' confidence of the accuracy of diagnosis and treatment plan was statistically higher for CBCT images (P <0.001).
These results showed that 2D and 3D images of impacted maxillary canines can produce different diagnoses and treatment plans.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Several conditions associated with dental eruption may generate soft/hard tissue periodontal impairments. Ectopic eruption occurs when the tooth erupts in facial or lingual version. Impaction is the absence of a tooth in the arch beyond the physiologic eruption time. The positional interchange of two adjacent teeth within the same quadrant is referred to as tooth transposition. These conditions can be treated with combined periodontal-orthodontic approaches following a careful interdisciplinary diagnosis and an accurate treatment plan. Preventive, interceptive or reconstructive mucogingival techniques are able to provide adequate periodontal tissues around teeth before, during and after orthodontic therapy, respectively. Therefore, periodontics and orthodontics are increasingly being considered complementary dental disciplines.
    Seminars in Orthodontics 09/2014; DOI:10.1053/j.sodo.2014.06.009
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cone-beam computed tomography (CBCT) is an advanced imaging modality that has high clinical applications in the field of dentistry. CBCT proved to be a successful investigative modality that has been used for dental and maxillofacial imaging. Radiation exposure dose from CBCT is 10 times less than from conventional CT scans during maxillofacial exposure. Furthermore, CBCT is highly accurate and can provide a three-dimensional volumetric data in axial, sagittal and coronal planes. This article describes the basic technique, difference in CBCT from CT and main clinical applications of CBCT.
    02/2015; 7(2):64-8.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The search for esthetic treatment has persisted in the routine of dental professionals. Following this trend, dental patients have sought treatment with the primary aim of improving smile esthetics. The aim of this article is to present a protocol to assess patient's smile: The 10 Commandments of smile esthetics.
    07/2014; 19(4):136-57. DOI:10.1590/2176-9451.19.4.136-157.sar