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Dias R, Kanungo H, Gupta M, Mishra K, Soni A, Jaiswal A. Comparison of 3D Easy Box cone-beam computed tomography analysis with 2D Modified Easy Box on OPG as a prognostic tool for impacted maxillary canines: A pilot study. J Orthod 2024:14653125241242138. [PMID: 38561938 DOI: 10.1177/14653125241242138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess and compare the validity of 2D modified Easy Box and measurement of the Beta angle on standard conventional orthopantomogram (OPG) versus 3D cone-beam computed tomography (CBCT) OPG-constructed view. DESIGN A retrospective agreement study. METHODS The aim of this study was to construct an Easy Box on a standard conventional OPG and to validate this novel method by comparing it with the Easy Box method on 3D CBCT. After approval from the Ethics Committee, OPG and CBCT radiographs were obtained for the study from departmental records and five private practices in the same location (Indore, India). The radiographs were selected based on record availability and with written consent from the participants before the commencement of the study. The records were analysed to enable a comparison and to assess the accuracy of Easy Box construction on both 3D CBCT and standard conventional OPG radiographs. The location of the impacted canine within the Easy Box boundaries and the measurement of the Beta angle were determined on both views. RESULTS A perfect agreement was obtained for the comparison of 3D Easy Box CBCT analysis with 2D modified Easy Box on OPG for impacted maxillary canines (Kappa = 1.0). A Bland-Altman (LoA) analysis showed no proportional bias in the comparison of the Beta angle on 3D and 2D OPG radiographs. CONCLUSION Beta angle and 2D modified Easy Box on a conventional OPG yield similar results when compared to Easy Box on 3D CBCT OPG-constructed view. The standard OPG was valuable and cost-effective, particularly in the early stages of diagnosis and treatment planning, either as a substitute or when CBCT was unavailable.
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Affiliation(s)
- Rochelle Dias
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Himanshu Kanungo
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Mukesh Gupta
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Kratika Mishra
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Akanksha Soni
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Aayush Jaiswal
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
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Salari B, Tofangchiha M, Padisar P, Reda R, Zanza A, Testarelli L. Diagnostic accuracy of conventional orthodontic radiographic modalities and cone-beam computed tomography for localization of impacted maxillary canine teeth. Sci Prog 2024; 107:368504241228077. [PMID: 38359866 PMCID: PMC10874157 DOI: 10.1177/00368504241228077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Orthodontic treatment planning for an impacted canine tooth requires accurate information about its position. The aim of this study was to compare the diagnostic accuracy of two conventional orthodontic radiographic modalities with cone-beam computed tomography (CBCT) for localization of impacted maxillary canine teeth. MATERIALS AND METHODS Panoramic radiographs, lateral cephalograms, and CBCT scans of 30 patients with unilaterally impacted maxillary canine teeth were retrieved from the archives. Eight expert orthodontists evaluated the parameters related to the location of impacted canine teeth by using panoramic radiographs and lateral cephalograms of patients. After 4 weeks, the same parameters were evaluated on CBCT scans of patients. The diagnostic accuracy of conventional modalities and CBCT was compared with each other and also with the gold standard. RESULTS The conventional radiographic modalities and CBCT had similar accuracy for assessment of the overall inclination (p = 0.11), apex morphology (p = 0.18), and mesiodistal position of the apex (p = 0.12). CBCT had significantly higher accuracy for determination of incisal tip location (p = 0.001), labiopalatal (p = 0.001) and vertical (p = 0.01) position of the crown tip, minimum bone thickness covering the crown (p = 0.001), and root resorption of the adjacent tooth (p = 0.001). CONCLUSION The combination of panoramic radiographs and lateral cephalograms was sufficiently accurate to assess some diagnostic parameters such as overall inclination, apex morphology, and mesiodistal apex location of impacted canine teeth.
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Affiliation(s)
- Behzad Salari
- Department of Orthodontics, School of Dentistry, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Maryam Tofangchiha
- Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Parviz Padisar
- Department of Orthodontics, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessio Zanza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Alfailany DT, Shaweesh AI, Hajeer MY, Brad B, Alhaffar JB. The diagnostic accuracy of cone-beam computed tomography and two-dimensional imaging methods in the 3D localization and assessment of maxillary impacted canines compared to the gold standard in-vivo readings: A cross-sectional study. Int Orthod 2023; 21:100780. [PMID: 37290351 DOI: 10.1016/j.ortho.2023.100780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Although the widespread cone-beam computed tomography (CBCT) is a diagnosing tool for impacted canines, the surgical exposure-based diagnostic accuracy of this 3D imaging modality has not been established yet. Therefore this study aimed to (1) compare the accuracy of CBCT- and 2D-based interpretations of impacted canine and its relationships with the neighbouring structures with the gold standard (GS) readings, (2) and calculate the diagnostic accuracy, sensitivity, and specificity values of the variables assessed using CBCT and 2D methods. MATERIAL AND METHODS Patients with unilateral impacted maxillary canines (IMCs) planned for surgical extraction between 2016-2018 were checked in-depth to include in this cross-sectional study. For each patient, 2D and 3D radiographic records were obtained and assessed by eight postgraduate orthodontic students. These assessments were compared with the GS readings based on surgical exposure and direct vision of the IMCs. To compare 2D- and CBCT-based assessments with the GS values, Cochran's Q tests, Friedman's tests, McNemar's, McNemar-Bowker's, and Wilcoxon tests were applied. RESULTS A total of 17 patients (6 males, 11 females; mean age: 20.52±3.98 years) were randomly selected and included in this study. Significant differences were found between the CBCT-based assessments and the GS only concerning shape and bony coverage of the IMC (P=0.001 and P<0.001, respectively). On the contrary, there were significant differences between the 2D-based assessments and the GS regarding all the assessed variables except for the ankylosis and the proximity to the adjacent teeth (P=0.424, and P=0.080, respectively). CBCT-based assessments had remarkably higher values of diagnostic accuracy, sensitivity, and specificity compared to 2D-based ones. CONCLUSIONS The diagnostic accuracy of CBCT outperformed 2D radiography in localizing the IMC (labiopalatal, mesiodistal, and vertical location), detecting root apex development of the IMCs, and the resorption of the adjacent incisors. Although both 2D and 3D techniques showed the same ability in the diagnosis of IMCs ankylosis, the diagnostic accuracy of CBCT was superior. However, both techniques inaccurately determined the shape of the impacted canine and the bony coverage.
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Affiliation(s)
| | - Ayman Ihsan Shaweesh
- Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, Syria
| | - Mohammad Younis Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, Syria.
| | - Bassel Brad
- Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, Syria
| | - Jacqueline Bashar Alhaffar
- Department of Oral and Maxillofacial Surgery, University of Damascus Faculty of Dentistry, Damascus, Syria
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Barrow S, Talbot J, Kindelan S, Walker E. The role of CBCT in paediatric dentoalveolar trauma: A service evaluation. Int J Paediatr Dent 2023; 33 Suppl 2:66-68. [PMID: 37665153 DOI: 10.1111/ipd.13111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Affiliation(s)
- S Barrow
- Paediatric Dentistry and Dental and Maxillofacial Radiology, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Talbot
- Paediatric Dentistry and Dental and Maxillofacial Radiology, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Kindelan
- Paediatric Dentistry and Dental and Maxillofacial Radiology, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - E Walker
- Paediatric Dentistry and Dental and Maxillofacial Radiology, Leeds Dental Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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MacDonald D, Alebrahim S, Yen E, Aleksejuniene J. Cone-beam computed tomographic reconstructions in the evaluation of maxillary impacted canines. Imaging Sci Dent 2023; 53:145-151. [PMID: 37405198 PMCID: PMC10315227 DOI: 10.5624/isd.20220211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT cross-sectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered. Materials and Methods Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm × 5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart. Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration. Results All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth. Conclusion Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features.
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Affiliation(s)
- David MacDonald
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sharifa Alebrahim
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Edwin Yen
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jolanta Aleksejuniene
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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Kareem FA, Rasheed TA, Rauf AM, Jalal RA, Faraj BM. Three-Dimensional Measurements of the Palate and Dental Arch Perimeter as Predictors for Maxillary Palatal Canine Impaction-A Cone-Beam Computed Tomography Image Analysis. Diagnostics (Basel) 2023; 13:diagnostics13101808. [PMID: 37238292 DOI: 10.3390/diagnostics13101808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Accurate diagnosis and treatment plans in orthodontics were facilitated by novel technologies. The prediction of occlusal problems is of utmost importance for clinicians. This present study aimed to find any possible correlation between unilateral and bilateral palatally impacted maxillary canine, palatal dimensions, and maxillary arch perimeter using digital measurements and determine the factors that could be used as predictors for maxillary palatal canine impaction. (2) Method: A cross-sectional study was conducted on cone-beam computed tomography images of orthodontic patients aged 15 to 25. Palatal dimensions and maxillary arch perimeter were digitally measured using Materialize Interactive Medical Image Control System. (3) Results: A significant difference was found between the case and the study groups regarding palatal depth, length, and arch perimeter, except for the palatal width. A weak correlation was reported in palatal depth and length with canine impaction, whereas the correlation was moderate concerning the arch perimeter. They can be used as predictors for palatal canine impaction. (4) Conclusion: Palatal dimensions and dental arch perimeter affect maxillary palatal canine impaction. Deficient arch perimeter, palatal depth, and length could be helpful in the prediction of maxillary palatal canine impaction.
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Affiliation(s)
- Fadil Abdullah Kareem
- Department of POP, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq
| | - Tara Ali Rasheed
- Department of POP, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq
| | - Aras Maruf Rauf
- Department of POP, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq
| | - Ranj Adil Jalal
- Department of Oral Diagnosis, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq
| | - Bestoon Mohammed Faraj
- Conservative Department, College of Dentistry, University of Sulaimani, Sulaimani 46001, Iraq
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P MS, Sundareswaran S, Mohammed F, Jisha B. Development and validation of a new prognostic tool for impacted maxillary canines, 'Easy box': A cone-beam computed tomographic study. J Orthod 2023; 50:69-76. [PMID: 36113095 DOI: 10.1177/14653125221122060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To develop a tool to facilitate simple, easy and rapid assessment of the level of difficulty in disimpaction of an impacted canine using cone-beam computed tomography (CBCT). DESIGN A cross-sectional study. METHODS A panel of four experienced orthodontists formulated a questionnaire capable of portraying the limits of a three-dimensional (3D) area around impacted maxillary canines on CBCT images, which would determine the disimpaction difficulty level. In total, 14 experienced orthodontists graded each item in the questionnaire and assigned scores in the range of 0-5. Average scores obtained outlined the limits of a 3D area, within which an impaction was deemed favourable. This area was termed 'Easy box'. The disimpaction difficulty level of 170 impacted maxillary canines was then assessed using 'Easy box' and the existing tool KPG index for convergent validation. RESULTS Perfect inter-examiner agreement was obtained as evidenced by Fleiss kappa value of 0.984 for the tool 'Easy box' and 0.948 for the KPG index. There was also perfect agreement between the two methods of assessment (Cohen weighted kappa, k>0.86). The average time taken for assessment using 'Easy box' was 3.3 min compared to 8.8 min for the KPG index. CONCLUSION 'Easy box' proves to be a simple, accurate and rapid assessment tool for the prognostic evaluation of impacted canines, using CBCT images. Impacted maxillary canines with cusp tips that lie beyond the limits of the 3D 'Easy box' area with a beta angle greater than 45°, were rated to be more difficult to align.
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Affiliation(s)
- Muhammed Shibin P
- Department of Orthodontics, Government Dental College, Calicut, KL, India
| | | | - Faraj Mohammed
- Department of Orthodontics, Government Dental College, Calicut, KL, India
| | - Baby Jisha
- Department of Orthodontics, Government Dental College, Calicut, KL, India
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Cone beam computed tomography indications for interdisciplinary therapy planning of impacted canines. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:e1-e9. [PMID: 36229372 DOI: 10.1016/j.oooo.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate how cone beam computed tomography (CBCT) affects the therapeutic planning of impacted maxillary canines. STUDY DESIGN A total of 132 impacted canines from 89 pediatric patients were collected from 3 specialist clinics in Stockholm, Sweden. An interdisciplinary therapy planning team consisting of 5 dental specialists evaluated each case and chose their preferred treatment alternative, initially without and later with CBCT images, to decide whether CBCT was justified for therapy planning. Predefined variables measurable using only 2-dimensional (2D) assessments were analyzed using stepwise logistic regression analyses. RESULTS The CBCT was considered indicated in 47% of the cases. Additional information from CBCT led to a treatment decision change in 9.8%. Significant 2D predictors for CBCT justification were horizontal canine angulation compared with vertical angulation (odds ratio [OR] = 10.9), extraction strategy involvement (OR = 6.7), and buccally positioned canines compared with palatal (OR = 5.3), central (OR = 25.0), and distal or uncertain positions (OR = 7.7). CONCLUSIONS The benefit-risk assessment of CBCT for impacted canines may be reinforced by performing and applying justification decisions for CBCT acquisition at the therapeutic thinking level. If preliminary treatment planning motivates further in-depth investigation of either root status or tooth location, a CBCT is indicated.
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Alhaija ESA, AlWahadni AM, Al-Tawachi A, Daher SO, Daher HO. Evaluation of maxillary sinus dimensions and volume using cone beam computed tomography in patients with unilaterally displaced palatal and buccal maxillary canines. Oral Radiol 2022:10.1007/s11282-022-00663-6. [PMID: 36380171 DOI: 10.1007/s11282-022-00663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To evaluate and compare the maxillary sinus (MS) dimensions and volume in unilaterally displaced palatal and buccal maxillary canines. METHODS CBCT images for 133 patients were included in the study. Maxillary canines were unilaterally displaced palatally in 83 patients (PDCs) and buccally in 50 patients(BDCs). The following variables were measured: canine position in relation to MS walls, MS pneumatization and MS dimensions and volume. RESULTS MS was extended to the incisor region in 10% and 13% and to the canine region in 48% and 23% in BDCs and PDCs subjects, respectively. In BDC subjects, maxillary canine crown tip was more laterally (24.23 mm compared to 22.93 mm (p < 0.05)) and closer vertically (5.82 mm compared to 9.58 mm (p < 0.001)) to the MS, maxillary canine root tip was closer to the MS anterior (0 mm compared to 1.64 mm (p < 0.05)) and lateral (19.70 mm compared to 22.02 mm (p < 0.001)) walls and the MS volume (11.57mm3 compared to 9.09 mm3 (p < 0.001)) was increased in the displaced side compared to the non-displaced side. In PDC subjects, a significant difference between the displaced and non-displaced sides was detected in the vertical (3.28 mm compared to 5.89 mm (p < 0.001)) and lateral (21.63 mm compared to 24.25 mm (p < 0.001)) position of maxillary canine to the MS wall, the anterior (- 0.84 mm compared to 1.13 mm (p < 0.05)) and lateral (20.48 mm compared to 22.44 mm (p < 0.001)) position of canine root tip to the MS and the MS volume (7.71mm3 compared to 9.14mm3 (p < 0.001)). PDC sides differed from BDC sides in the lateral and vertical position of canine crown tip to MS and in MS volume. PDC showed negative association with MS volume and anteroposterior skeletal relationship and a positive association with MS height. CONCLUSIONS PDCs subjects have a reduced MS volume and BDCs subjects have an increased MS volume. PDCs are associated with reduced MS volume, increased MS height and Class III skeletal relationship.
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Affiliation(s)
- Elham S Abu Alhaija
- College of Dental Medicine, QU Health, Qatar University, P.O. Box: 2713, Doha, Qatar.
| | - Ahed M AlWahadni
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, P.O. Box 3030, Jordan
| | | | - Saba O Daher
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, P.O. Box 3030, Jordan
| | - Hasan O Daher
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, P.O. Box 3030, Jordan
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The Interdisciplinary Orthodontic–Surgical Diagnostic and Treatment Protocol for Odontogenic Cyst-like Lesions in Growing Patients—A Literature Review and Case Report. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Tooth eruption disturbances associated with developmental odontogenic cysts represent a particular challenge in orthodontic treatment. Early diagnosis, crucial for prompt and effective therapy, is possible with a thorough radiological analysis. Three-dimensional digital images provided by CBCT are indispensable to establish an interdisciplinary orthodontic–surgical treatment plan. The aim of this paper is to present a case of an odontogenic cyst in a nine-year-old male patient. Particular attention is paid to radiological findings, possible therapeutic approaches and potential complications connected with an attempt to improve the alignment of teeth. Orthodontic implications associated with cysts in growing patients are widely described according to clinical observations and literature review.
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Al-Kyssi HA, Al-Mogahed NM, Altawili ZM, Dahan FN, Almashraqi AA, Aldhorae K, Alhammadi MS. Predictive factors associated with adjacent teeth root resorption of palatally impacted canines in Arabian population: a cone-beam computed tomography analysis. BMC Oral Health 2022; 22:220. [PMID: 35658855 PMCID: PMC9166389 DOI: 10.1186/s12903-022-02249-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background This study aimed to evaluate three-dimensionally the factors associated with adjacent teeth root resorption of palatally impacted canines. Methods In this retrospective cross-sectional study, one-hundred and fourteen cone beam computed tomography scans with palatally impacted maxillary canines were evaluated for the presence of adjacent root resorption. Seven parameters were analyzed: alignment of maxillary incisors, presence of deciduous canines, first premolars’ roots configuration, impacted canines rotation, angulation of impacted canine to the midline, contact relationship, and area of contact with adjacent teeth. The association between dependent and independent qualitative and quantitative variables was analyzed using chi-square and independent student’s t-test, respectively. The multivariate analysis was performed using regression analysis. The significant value was set at P ≤ 0.05. Results The overall incidence of vertical, horizontal impaction and adjacent root resorption were 92, 8 and 77.2%, respectively. The apical third was the most involved area (57%); resorption of a single tooth was found in 21.9% of the total sample. The most common resorbed teeth were lateral first premolars (24.6%), followed by central lateral incisors (20.2%), and lateral incisors (15.8%) of the total sample. The severity of resorption was highest in grade I (31.5%) and lowest in grade III (7.6%). Three variables showed significant differences between resorption and non-resorption groups namely; canine rotation (P < 0.013), contact relationship (P < 0.001), and area of contact with adjacent teeth (P < 0.001). Regression analysis revealed an association between adjacent root resorption and permanent canine rotation, adjacent premolars’ roots configuration, contact relationship, and area of contact (P < 0.05). Conclusion Two-thirds of impacted maxillary canines showed a form of root resorption. The most commonly resorbed tooth was the lateral incisors while the least affected one was the central incisors with apical one-third being of the highest risk. The predisposing factors including the canine rotation, premolar with separated roots, contact relationship, and area of contact with adjacent teeth are to be considered for any interceptive treatment.
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Evaluation of the diagnostic accuracy of CBCT-based interpretations of maxillary impacted canines compared to those of conventional radiography: An in vitro study. Int Orthod 2022; 20:100639. [DOI: 10.1016/j.ortho.2022.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/11/2022] [Accepted: 04/18/2022] [Indexed: 11/23/2022]
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Andresen AK, Jonsson MV, Sulo G, Thelen DS, Shi XQ. Radiographic features in 2D imaging as predictors for justified CBCT examinations of canine-induced root resorption. Dentomaxillofac Radiol 2022; 51:20210165. [PMID: 34324382 PMCID: PMC8693324 DOI: 10.1259/dmfr.20210165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES This retrospective observational study aimed to evaluate the diagnostic accuracy of two-dimensional radiographs on canine-induced root resorption (CIRR) in lateral incisors and identify predictors of CIRR in patients with impacted maxillary canines (IMC). METHODS Ninety-nine patients aged 9-17 years, with 156 IMCs, were included in the study. All had CBCT-volumes and two-dimensional radiographs consisting of at least one panoramic radiograph. Two radiologists jointly viewed all cases twice. First, radiographic features related to the IMC and possible CIRR were recorded from two-dimensional radiographs. Then, CIRR was determined from CBCT and according to position and extension classified as mild, moderate and severe. RESULTS CIRRs was detected in 80% of lateral incisors (mild: 45%; moderate: 44%; severe: 11%). The sensitivity was generally low at mild and moderate cut-offs (29 and 29%), and somewhat higher for severe (50%). Corresponding specificities were 48%, 63% and 68%. Canine cusp-tip superimposing the lateral incisor's middle third and root/crown ratio >1 was positively associated with mild CIRR, with an odds ratio (OR) of 3.8 and 6.7, respectively. In addition, the root development stage was positively associated with moderate/severe CIRR when the canine root was nearly or fully developed (OR = 3.1). CONCLUSIONS The diagnostic accuracy of two-dimensional radiographs was inadequate for detecting CIRR amongst patients referred for CBCT examinations. Based on our results, none of the suggested two-dimensional radiographic features could predict moderate/severe CIRR except for root development stage. IMC in a later stage of root development seems to be associated with a higher risk of moderate/severe CIRR.
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Affiliation(s)
- Amanda K.H. Andresen
- Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Norway, United Kingdom
| | | | | | - Dorina S. Thelen
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway, United Kingdom
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Evaluation of impacted maxillary canine position using panoramic radiography and cone beam computed tomography. Saudi Dent J 2021; 33:738-744. [PMID: 34803328 PMCID: PMC8589574 DOI: 10.1016/j.sdentj.2020.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/26/2020] [Accepted: 03/24/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Localization of impacted maxillary canine (IMC) position is essential in orthodontic treatment for accurate orthodontic treatment as well as prognosis. Objectives This study aimed to: 1- investigate the relationship between the locations of IMC in panoramic radiograph (PR) using sectors in relation to their labio-palatal position in cone beam computed tomography (CBCT): 2- report the incisor root resorption in CBCT in relation to its sector location of IMC in PR. Material and Methods The study is a retrospective imaging assessment of 60 IMCs in multiple centers in Riyadh, Saudi Arabia. Sector location of IMC was determined on the PR and correlated with each of their labio-palatal positions and resorption of the root of permanent incisors using CBCT. Results There is a significant correlation between sector location and impaction location of IMC. No statistical correlation was found between IMC sector location and lateral incisor root resorption, whereas a significant correlation was found between sector location and central incisor root resorption. Conclusions For Sectors I and II, IMC tended to be in either the mid-alveolus or labial location, whereas Sectors III and IV tended to show palatal impaction. Therefore, sector could be a good tool for localization of IMC and to predict the possibility of incisor root resorption.
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Image quality assessment of low-dose protocols in cone beam computed tomography of the anterior maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:483-491. [PMID: 34742681 DOI: 10.1016/j.oooo.2021.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate overall image quality and visibility of anatomic structures on low-dose cone beam computed tomography (CBCT) scans and the effect of a noise reduction filter for assessment of the anterior maxilla. METHODS We obtained 48 CBCT volumes on 8 skull-phantoms using 6 protocols: 2 clinical default protocols [standard definition (SD) and high definition (HD)] and 4 low-dose protocols, 2 with a noise reduction filter [ultra-low-dose with high definition (ULDHD) and ultra-low-dose (ULD)] and 2 without [low-dose with high definition (LDHD) and low-dose (LD)]. Overall image quality and visibility of 8 anatomic structures were assessed by 5 observers and statistically analyzed using the Wilcoxon signed rank test. Intra- and interobserver agreement was measured using Cohen's weighted kappa. RESULTS HD provided higher overall image quality than diagnostically required; LD scored lower than diagnostically acceptable. ULDHD, ULD, and LDHD were acceptable. For anatomic structures, ULDHD and ULD were acceptable. LDHD and LD showed significantly inferior visibility for 1 and 4 structures, respectively. Mean values of intra- and interobserver agreement were 0.395 to 0.547 and 0.350 to 0.370, respectively. CONCLUSIONS ULDHD, ULD, and LDHD may be recommended for assessment of impacted maxillary canines. The noise reduction filter affects image quality positively only at low exposure.
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Friedlander-Barenboim S, Hamed W, Zini A, Yarom N, Abramovitz I, Chweidan H, Finkelstein T, Almoznino G. Patterns of Cone-Beam Computed Tomography (CBCT) Utilization by Various Dental Specialties: A 4-Year Retrospective Analysis from a Dental and Maxillofacial Specialty Center. Healthcare (Basel) 2021; 9:1042. [PMID: 34442182 PMCID: PMC8392371 DOI: 10.3390/healthcare9081042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/08/2021] [Accepted: 08/10/2021] [Indexed: 01/30/2023] Open
Abstract
The study aimed to analyze the uses of cone-beam computed tomography (CBCT) in the diagnosis and treatment in various dental specialties. This 4-year cross-sectional study analyzed the records of 1409 individuals who underwent a CBCT at the Oral and Maxillofacial Center at Sheba Medical Center, Israel. The average age of the patients was 27.9 ± 11.5 (range: 9-86 years). Patients were referred for CBCT by the following departments: Oral and Maxillofacial Surgery (1063; 75.5%), Endodontics (182; 12.9%), Periodontology (122; 8.6%) and Orthodontics (42; 3.0%). Most CBCT radiographs evaluated the maxilla (774; 55.0%), followed by the mandible (481; 34.1%) and both (154; 10.9%). The target anatomical structures included: bone (694; 49.3%), teeth (307; 21.7%), and both jaws (408; 29.0%). The main indications for CBCT use were: assessment of anatomical structures and implant sites (787; 55.9%), determine root canals morphology (182; 12.9%), visualization of impacted teeth, tooth alignment, and localization (177; 12.6%), suspected cysts or tumors (148; 10.5%), evaluation of Temporomandibular joint disorders (106; 7.5%) and other reasons (9; 0.6%). In 279 (19.8%) of cases, the diagnosis changed following CBCT, mainly in Orthodontics tooth analysis (28 (66.7%); p < 0.001). Practitioners and health authorities should be aware of this baseline information regarding CBCT use in the diagnosis and assessment of various oral and maxillofacial pathologies, anomalies and tooth position relative to anatomic structures. Continuing research and publications of CBCT utilization and guidelines are recommended.
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Affiliation(s)
| | - Wafi Hamed
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Avraham Zini
- Hadassah Medical Center, Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Noam Yarom
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
| | - Itzhak Abramovitz
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
| | - Harry Chweidan
- Oral and Maxillofacial Center, Department of Prosthodontics, Israel Defense Forces Medical Corps, Tel-Hashomer, Ramat Gan 02149, Israel; (W.H.); (H.C.)
| | - Tamar Finkelstein
- The Sheba Medical Center, Tel-Hashomer, Oral Medicine Unit, Ramat Gan 5265601, Israel; (S.F.-B.); (N.Y.); (T.F.)
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel
| | - Galit Almoznino
- Hadassah Medical Center, Department of Endodontics, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel;
- Hadassah Medical Center, Department of Oral Medicine, Sedation & Maxillofacial Imaging, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
- Hadassah Medical Center, Big Biomedical Data Research Laboratory, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 91120, Israel
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Hamada Y, Timothius CJC, Shin D, John V. Reprint of canine impaction - A review of the prevalence, etiology, diagnosis and treatment. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ardakani MP, Nabavizadeh A, Iranmanesh F, Hosseini J, Nakhaei M. Relationship of Angulation of Maxillary Impacted Canines with Maxillary Lateral Incisor Root Resorption. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Prognosis for the impacted lower third molars: Panoramic reconstruction versus tomographic images. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:625-631. [PMID: 32981872 DOI: 10.1016/j.oooo.2020.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/18/2020] [Accepted: 07/11/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this cross-sectional accuracy study was to compare panoramic reconstruction (PR) and multiplanar reconstruction (MPR) images, which are used to establish the prognosis for impacted mandibular third molars in relation to professional decision making. STUDY DESIGN Images of 10 patients who had undergone cone beam computed tomography (CBCT) examination were selected, resulting in 2 distinct groups of images, with 10 in each group: PR and MPR. To check prognostic accuracy, 2 images from each group were randomly selected and reinserted into the sample, totaling 24 images. A questionnaire was completed by 54 professionals: 27 orthodontists and 27 oral and maxillofacial surgeons (OMFSs). Data were evaluated by using the χ2 and McNemar's tests and Kappa statistics at P < .05. RESULTS There were no statistically significant differences when isolated PR images were compared with MPR images by orthodontists (P = .72) or OMFSs (P = .45). However, there were significant differences in the professional decision regarding the prognosis for impacted teeth, where OMFSs indicated the need for more extractions compared with orthodontists (P < .0001). CONCLUSIONS There are no differences between PR and multiplanar CBCT images with regard to the determination of the prognosis for impacted mandibular third molars. However, there was a difference in the decision making between the different specialties.
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De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. Eur J Orthod 2020; 41:381-389. [PMID: 30351398 PMCID: PMC6686083 DOI: 10.1093/ejo/cjy066] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. OBJECTIVE The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. SEARCH METHODS MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. SELECTION CRITERIA The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. DATA COLLECTION AND ANALYSIS Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. RESULTS As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. CONCLUSIONS CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. REGISTRATION None. CONFLICT OF INTEREST None to declare.
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Affiliation(s)
- Annelore De Grauwe
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Irem Ayaz
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | | | | | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Katholieke Universiteit Leuven.,DentoMaxillofacial Radiology Center, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Akkuc S, Duruk G, Duman S. Evaluation of impacted canines' localization and adjacent lateral incisors' root resorption with orthopantomography and cone-beam computed tomography. Oral Radiol 2020; 37:476-486. [PMID: 32949336 DOI: 10.1007/s11282-020-00482-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES In this retrospective study, the frequency and severity of ectopic eruption in the children's permanent canines, changes between the impacted canine parameters on orthopantomography (OPG) taken for routine follow-up were demonstrated. Also, it was aimed to reveal the differences between OPG and cone beam computed tomography (CBCT). METHODS Ten thousand (5020 girls, 4980 boys) pediatric patient, were retrospectively investigated for the presence of impacted canine radiographically. OPG and CBCT images of 343 pediatric patients (207 girls, 136 boys) detected impacted canines (n = 432) were evaluated in four steps that the angular and linear measurement, position and status relationships with adjacent anatomical structures were investigated. RESULTS The incidence of impacted canine in children was 3.43% (4.02% girls, 2.73% boys). The percentage of adjacent lateral incisor' resorption was 33%. Although the presence of resorption in lateral incisors in contact with a canine was found to be statistically significant (p = 0.02), there was no statistically significant relationship the follicle size and localization of canine in the transverse plane. When images were compared, it was found that there was a statistically significant difference between CBCT and OPG about the parameter of canine angulation to the midline and parameter of canine angulation to the lateral incisor. CONCLUSIONS Pediatric dentists should prefer OPG as the first choice for radiographic imaging for the diagnosis of impacted canine at an early age. Follow-up OPGs should be carefully studied with advancing age. The CBCT should be preferred to prevent complications, to view its relationship with adjacent anatomical structures and canine localization in detail.
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Affiliation(s)
- Sibel Akkuc
- Department of Pediatric Dentistry, Faculty of Dentistry, Inönü University, 44280, Malatya, Turkey
| | - Gulsum Duruk
- Department of Pediatric Dentistry, Faculty of Dentistry, Inönü University, 44280, Malatya, Turkey.
| | - Sacide Duman
- Department of Pediatric Dentistry, Faculty of Dentistry, Inönü University, 44280, Malatya, Turkey
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Abstract
Impacted incisors, canines, premolars, and second molar are problems encountered frequently by general dentists, orthodontists, and oral and maxillofacial surgeons. The etiology of impacted teeth is multifactorial. Traditional radiographs can be used for location of the impacted tooth but 3-D CBCT is superior in evaluating the tooth's position. Successful management requires an interdisciplinary approach with an orthodontist responsible for the overall success of the treatment plan. Surgical exposure of these impacted teeth is accomplished using an open or closed surgical procedure. Choosing the appropriate surgical procedure and orthodontic treatment plan will result in a stable, predictable, and aesthetic result.
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Padisar P, Tofangchiha M, Salari B, Oveisi S. Comparison of Three-Dimensional and Conventional Orthodontic Imaging Modalities for Localization of Impacted Maxillary Canines in Patients With Alveolar Cleft. Cleft Palate Craniofac J 2020; 58:202-207. [PMID: 32783463 DOI: 10.1177/1055665620946980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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.
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Affiliation(s)
- Parviz Padisar
- Department of Orthodontics, 113375School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Tofangchiha
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, 113375Qazvin University of Medical Sciences, Qazvin, Iran
| | - Behzad Salari
- Department of Orthodontics, School of Dentistry, 162996AJA University of Medical Sciences, Tehran, Iran.,School of Dentistry, 48491Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sonia Oveisi
- Metabolic Diseases Research Center, School of Medicine, 48491Qazvin University of Medical Sciences, Qazvin, Iran
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Diagnostic efficacy of and indications for intraoral radiographs in pediatric dentistry: a systematic review. Eur Arch Paediatr Dent 2020; 21:429-462. [PMID: 32390073 DOI: 10.1007/s40368-020-00532-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/27/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To systematically evaluate the diagnostic efficacy of intraoral radiographs and evidence supporting the indications for taking of intraoral radiographs in children in the following five clinical categories: caries, pathological conditions (including acute odontogenic infections and periodontal disease), dental/developmental anomalies, dental trauma, and enhancement of comfort/technique for taking radiographs in children. This was carried out to facilitate the updating of existing European Academy of Paediatric Dentistry (EAPD) guidelines on dental radiography in pediatric dentistry. METHODS A systematic electronic literature search was conducted on Cochrane Library (1992-24 July 2018), MEDLINE (PubMed, 1946-24 July 2018), EMBASE (Embase.com, 1974-24 July 2018) and Scopus (pre-1970-24 July 2018). Hand search of handbooks and grey literature search was also performed. Study screening and study inclusions were agreed upon by three authors. Data extraction, and methodological quality and risk of bias assessment were carried out in duplicate for each of the included studies. RESULTS A total of 9581 papers were identified. Following the primary and secondary assessment process, 36 papers were included in the final analysis. The included studies were further categorized into five main clinical categories for analysis: caries, pathological conditions, dental/developmental anomalies, dental trauma and comfort/technique-related studies. Only one paper was found to be of good quality and at low risk of bias; while, 9 papers were found of be at moderate risk of bias and 26 papers were at high risk of bias. Meta-analysis was not possible for any of the aforementioned clinical situations, and only a narrative synthesis was done. CONCLUSION There is insufficient high-quality evidence for the use of intraoral radiographs in pediatric dentistry and current guidelines are based largely on expert opinion. There is a clear need for well-conducted and standardized studies regarding the use of intraoral radiography in pediatric dentistry.
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Hou D, Capote R, Bayirli B, Chan DCN, Huang G. The effect of digital diagnostic setups on orthodontic treatment planning. Am J Orthod Dentofacial Orthop 2020; 157:542-549. [PMID: 32241361 DOI: 10.1016/j.ajodo.2019.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION This study aimed to evaluate whether viewing digital treatment simulations influenced orthodontic treatment planning decisions or practitioners' confidence in their selected plans. METHODS Records of 6 patients representing different case types (eg, missing teeth, crowding, sagittal discrepancies) were collected. A total of 22 orthodontists and 7 orthodontic residents viewed these records and formulated treatment plans for each case, indicating their most recommended plan and up to 2 alternative plans. After treatment planning each case, digital setups of each treatment plan indicated by the practitioner were shown. The practitioners were then asked if they still recommended their original plan, or if they would now recommend a different plan. Their confidence levels in the success of their plans were recorded before and after viewing the setups. RESULTS After viewing the digital setups, there was a significant change in the treatment plan for 9.2% of the cases. These included modifications like changing the extraction pattern or proposing space closure rather than opening space for an implant. In an additional 14.4% of the cases, treatment plans underwent partial changes, like adding interproximal reduction or temporary anchorage devices. Practitioner confidence levels increased after viewing the setups. In cases where the treatment plan changed, the practitioner's confidence level in the plan increased the most, and the final confidence level was uniformly high among all practitioners. Practitioners reported the most helpful features of digital setups were the ability to superimpose the setup with the original model, determine the amount of tooth movement needed, check the final incisal relationship (overjet and overbite), and establish the amount of interproximal reduction required. CONCLUSIONS Viewing digital setups resulted in changes to the treatment plans in about 24% of the cases. The use of digital setups was associated with higher levels of confidence in the selected plans.
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Affiliation(s)
- Derek Hou
- Department of Orthodontics, School of Dentistry, University of Washington, Seattle, Wash; Private Practice, Vancouver, British Columbia, Canada.
| | - Raquel Capote
- Department of Orthodontics, School of Dentistry, University of Washington, Seattle, Wash
| | - Burcu Bayirli
- Department of Orthodontics, School of Dentistry, University of Washington, Seattle, Wash
| | - Daniel C N Chan
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Greg Huang
- Department of Orthodontics, School of Dentistry, University of Washington, Seattle, Wash; Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Wash
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Simić S, Pavlović J, Vukićević V, Vujačić A. The frequency of bucal and palatal impaction maxillary canines. PRAXIS MEDICA 2020. [DOI: 10.5937/pramed2004033s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Maxillary canines are usually impacted teeth the second after third molar. Frequency of impacted maxillary canines is about 1 to 3% of population (in 85% of the cases palataly, and in 15% of the cases bucaly). The aim of this research was to find the frequency of bucal and palatal impacted maxillary canines in relation to sex and position of impacted tooth. Matherial and method: We analyzed three-dimensional computed tomography images (CBCT) of 64 examinees (aged 12 to 33 years) with 80 unerupted maxillary canines to plan the orthodontic therapy. Results: Among 64 examines with impactions, 80 impacted maxillary canines are diagnosed. The average age of all respondents in the survey is 16,3±4,3. Of 64 examinees in research 41(64.1%) were female which is significantly more important than the representation of male examinees whose number was 23(35.9%). Frequency of unilateral impactions of maxillary canines is three times higher 48 (75%) in comparison to bilateral impactions 16 (25%). Of total 80 impacted maxillary canines 19 (23.75%) were bucal impacted, 3 (2.75%) in the middle of alveolus and 58 (72.5%) palatally. With the bucal and palatal impaction usually was represented partially vertical impaction (70%); completely horizontal impaction (10%) was represented only in the palatal impaction. Conclusion: The analysis of CBCT images of maxilla shows a statistically significant frequency of partially vertical, unilateral and paltally localized impacted maxillary canines.
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Alemam AA, Abu Alhaija ES, Mortaja K, AlTawachi A. Incisor root resorption associated with palatally displaced maxillary canines: Analysis and prediction using discriminant function analysis. Am J Orthod Dentofacial Orthop 2020; 157:80-90. [DOI: 10.1016/j.ajodo.2019.08.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/01/2019] [Accepted: 08/01/2019] [Indexed: 11/27/2022]
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Horner K, Barry S, Dave M, Dixon C, Littlewood A, Pang CL, Sengupta A, Srinivasan V. Diagnostic efficacy of cone beam computed tomography in paediatric dentistry: a systematic review. Eur Arch Paediatr Dent 2019; 21:407-426. [PMID: 31858481 PMCID: PMC7415745 DOI: 10.1007/s40368-019-00504-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
Abstract
Purpose To determine in which clinical situations it is indicated or contra-indicated to prescribe cone beam computed tomography (CBCT) for paediatric patients. Methods Systematic review of in vivo paediatric research studies of diagnostic efficacy using CBCT, with supplementary searches for guideline documents on CBCT and for systematic reviews permitting inclusion of ex vivo and adult studies. Results After screening, 190 publications were included, mostly case studies. No systematic reviews were found of in vivo paediatric research. Fourteen studies of diagnostic efficacy were identified. The supplementary searches found 18 guideline documents relevant to the review and 26 systematic reviews. The diagnostic efficacy evidence on CBCT was diverse and often of limited quality. There was ex vivo evidence for diagnostic accuracy being greater using CBCT than radiographs for root fractures. The multiplanar capabilities of CBCT are advantageous when localising dental structures for surgical planning. Patient movement during scanning is more common in children which could reduce diagnostic efficacy. Conclusions No strong recommendations on CBCT are possible, except that it should not be used as a primary diagnostic tool for caries. Guidelines on use of CBCT in the paediatric age group should be developed cautiously, taking into account the greater radiation risk and the higher economic costs compared with radiography. CBCT should only be used when adequate conventional radiographic examination has not answered the question for which imaging was required. Clinical research in paediatric patients is required at the higher levels of diagnostic efficacy of CBCT. Electronic supplementary material The online version of this article (10.1007/s40368-019-00504-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK.
- Dental Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK.
| | - S Barry
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - M Dave
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
| | - C Dixon
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - A Littlewood
- Information Specialist, Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
| | - C L Pang
- Division of Imaging, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - A Sengupta
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Coupland Building 3, Manchester, M13 9PL, UK
- Dental Radiology, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
| | - V Srinivasan
- Paediatric Dentistry, University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester, M15 6FH, UK
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Factors affecting forced eruption duration of impacted and labially displaced canines. Am J Orthod Dentofacial Orthop 2019; 156:808-817. [DOI: 10.1016/j.ajodo.2018.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/01/2018] [Accepted: 12/01/2018] [Indexed: 11/22/2022]
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Schriber M, Rivola M, Leung YY, Bornstein MM, Suter VGA. Risk factors for external root resorption of maxillary second molars due to impacted third molars as evaluated using cone beam computed tomography. Int J Oral Maxillofac Surg 2019; 49:666-672. [PMID: 31676229 DOI: 10.1016/j.ijom.2019.09.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/13/2019] [Accepted: 09/24/2019] [Indexed: 01/03/2023]
Abstract
The purpose of this retrospective study was to evaluate risk factors for external root resorption (ERR) on maxillary second molars (MxM2) in association with impacted third molars (MxM3) using cone beam computed tomography (CBCT) scans. The angles between the axes of MxM2/MxM3 (inclination) were measured. Further, ERR on MxM2 was classified as absent, slight, moderate, or severe. Contact location between MxM3 and MxM2, the size of the dental follicle, type of impaction, root formation, and patient demographic characteristics were also assessed. Half of the 84 MxM2 showed ERR (slight 36.9%, moderate 6.0%, severe 7.1%). Patient age was a significant factor for the presence of ERR (P = 0.03). The inclination was also a relevant factor, with transverse MxM3 exhibiting the highest risk of ERR (P = 0.02). The cervical third (28.6%) showed a significantly lower risk percentage of ERR compared to the apical (73.7%) and middle thirds (60.6%) of the root (P = 0.004). Based on these findings, clinicians assessing the need for surgical removal should be able to selectively identify impacted MxM3 at risk of causing ERR on MxM2 early on, especially when the MxM3 is located in close contact with the apical and middle thirds of the MxM2 roots and has a transverse inclination.
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Affiliation(s)
- M Schriber
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - M Rivola
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Y Y Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - M M Bornstein
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - V G A Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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31
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Dabbaghi A, Sharifi S, Esmaeili M. Accuracy of High- and Low-Resolution Cone-Beam Computed Tomographic Scans in the Detection of Impacted Tooth-Induced External Root Resorption: An Ex-Vivo Study. Front Dent 2019; 16:429-435. [PMID: 33089244 PMCID: PMC7569271 DOI: 10.18502/fid.v16i6.3442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 10/10/2019] [Indexed: 11/24/2022] Open
Abstract
Objectives: Cone-beam computed tomography (CBCT) is used in diagnostic situations, as well as tooth impaction and its complications. A possible sequela of tooth impaction is resorption of adjacent teeth, complicating the treatment plans. This study aimed to determine the diagnostic accuracy of high- and low-resolution CBCT scans in the detection of external root resorptions (ERRs), caused by an adjacent impacted tooth in the cementoenamel junction (CEJ), mid-root, and apical areas. Materials and Methods: Forty-five intact single-rooted teeth were divided into three groups of 15. Each group was dedicated to each zone of the root. Slight, moderate, and severe ERRs were formed, and CBCT scans were taken before and after the formation of ERRs. The diagnostic accuracy was assessed, and the Proportion test was used to compare the results. Results: The statistical analyses of high- and low-resolution images showed a significant difference (P<0.05), which implies the higher accuracy of high-resolution images. The highest diagnostic accuracy among different zones was related to the mid-root, and the lowest was related to the apical zone. In terms of the size of ERRs, the diagnostic accuracy was the lowest for slight ERRs. Conclusion: The most reliable and accurate diagnostic mode was found in high-resolution images, in the mid-root zone, and with severe ERRs. The lowest diagnostic accuracy was found in low-resolution images, in the apical zone, and with slight ERRs.
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Affiliation(s)
- Arash Dabbaghi
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sanaz Sharifi
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoud Esmaeili
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Abdelkarim A. Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:E89. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Affiliation(s)
- Ahmad Abdelkarim
- Department of Orthodontics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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33
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Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines. Clin Oral Investig 2019; 24:897-905. [DOI: 10.1007/s00784-019-02904-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/04/2019] [Indexed: 11/26/2022]
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Hamada Y, Timothius CJC, Shin D, John V. Canine impaction – A review of the prevalence, etiology, diagnosis and treatment. Semin Orthod 2019. [DOI: 10.1053/j.sodo.2019.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Weiss R, Read-Fuller A. Cone Beam Computed Tomography in Oral and Maxillofacial Surgery: An Evidence-Based Review. Dent J (Basel) 2019; 7:dj7020052. [PMID: 31052495 PMCID: PMC6631689 DOI: 10.3390/dj7020052] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/24/2022] Open
Abstract
Cone Beam Computed Tomography (CBCT) is a valuable imaging technique in oral and maxillofacial surgery (OMS) that can help direct a surgeon’s approach to a variety of conditions. A 3-dimensional analysis of head and neck anatomy allows practitioners to plan appropriately, operate with confidence, and assess results post-operatively. CBCT imaging has clear indications and limitations. CBCT offers the clinician 3-dimensional and multi-planar views for a more accurate diagnosis and treatment without the financial burden and radiation exposure of conventional computed tomography (CT) scans. Furthermore, CBCT overcomes certain limitations of 2-dimensional imaging, such as distortion, magnification, and superimposition. However, CBCT lacks the detailed depiction of soft tissue conditions for evaluation of pathologic conditions, head and neck infections, and temporomandibular joint (TMJ) disc evaluation. This review evaluates the evidence-based research supporting the application of CBCT in the various fields of oral and maxillofacial surgery, including dentoalveolar surgery, dental implants, TMJ, orthognathic surgery, trauma, and pathology, and will assess the value of CBCT in pre-operative assessment, surgical planning, and post-operative analysis when applicable. Additionally, the significant limitations of CBCT and potential areas for future research will be discussed.
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Affiliation(s)
- Robert Weiss
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
| | - Andrew Read-Fuller
- Department of Oral and Maxillofacial Surgery, Texas A&M University College of Dentistry, Dallas, TX 75246, USA.
- Attending Physician, Baylor Scott and White Health, Baylor University Medical Center-Dallas, Dallas, TX 75246, USA.
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Portelli M, Nucera R, Fastuca R, Cicciù M, Lo Giudice A, Militi A. Use of 3D Imaging for Treatment Planning in Cases of Impacted Canines. Open Dent J 2019. [DOI: 10.2174/1874210601913010137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The use of 3D imaging offers the possibility to improve diagnosis and treatment planning in several fields of dental science.
Objective:
The aim of this study is to evaluate the usefulness of 3D evaluation for surgical exposure treatment planning in cases of impacted canine.
Methods:
This retrospective study has been conducted on the clinical reports of twenty patients (11 F - 9 M) with a mean age of 15.4 years, affected by the impacted canine. Each patient underwent a CBCT exam (Hitachi MercuRay, Hitachi Medical Technology, Tokyo, Japan), in order to obtain sagittal, axial and coronal images and a 3D surface rendering. The images have been evaluated by 14 experts orthodontists who were divided into two groups. The first group first evaluates the bidimensional images and then the 3D images and the second group instead has done exactly the opposite. Each orthodontist has elaborated a treatment plan for the impacted canine correction with a specific indication about surgical exposure approach (Palatal-Vestibular) and orthodontic biomechanics.
Results:
The level of concordance in treatment planning of the 3D images evaluation and the bidimensional images was found to be greater in the second group of orthodontists. Moreover, in this group, the time spent for the treatment plan has been lower than in the first group (12 ± 3.32 min vs. 23 ± 2.53 min, p < 0.05).
Conclusion:
According to the results of the present study, it is possible to state that CBTC is fundamental for the diagnosis and treatment planning of impacted canine. However, further studies are necessary to confirm the greater reliability of 3D surface rendering compared to the bidimensional images.
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Are panoramic radiographs good enough to render correct angle and sector position in palatally displaced canines? Am J Orthod Dentofacial Orthop 2019; 155:380-387. [PMID: 30826041 DOI: 10.1016/j.ajodo.2018.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The early interceptive treatment of palatally displaced canines (PDCs) has for decades been based on their position in panoramic radiographs. In the 1990s, cone-beam computed tomography (CBCT) started to become popular in cases with PDCs. The aims of this prospective study were to evaluate the agreement of PDC sector position and angle to midline between panoramic radiographs and CBCT scans. METHODS PDC sector and angle to midline were measured in panoramic radiographs and CBCT scans in 58 consecutive patients with 64 PDCs. Kappa with linear weighting was used to assess the agreement between the measurements of PDC sector position and Bland-Altman limits of agreement to assess the agreement between the PDC angular measurements in the 2 methods. RESULTS PDC sector position and angle to midline had systematically higher values in panoramic radiographs compared with those in the CBCT scans. The agreement of sector position between the methods was fair: weighted kappa 0.36 (95% CI 0.24-0.49). The mean difference in angle was almost 7° (95% CI 5.9°-7.9°) higher in panoramic radiographs compared with CBCT. CONCLUSIONS Panoramic radiographs overestimate PDC sector and angle to midline position, compared with the use of CBCT scans, but clinically the differences are quite modest. Panoramic radiographs could be considered good enough for rendering PDC position when the need for 3D information is not crucial for treatment planning.
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Malik DES, Fida M, Sukhia RH. Correlation between radiographic parameters for the prediction of palatally impacted maxillary canines. J Orthod 2019; 46:6-13. [DOI: 10.1177/1465312518823012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study aimed to identify radiographic parameters on routine orthopantomograms to aid in early diagnosis of palatally impacted canines. Design: Split-mouth case-control study. Setting: Single-centre university dental hospital. Methods: Thirty-three individuals with palatally impacted canines and non-impacted contra-lateral teeth were recruited. Radiographic variables angle A, angle B, angle C, distance D, sector class and depth of vertical impaction were measured for both groups. Mann–Whitney U test and Spearman’s correlation coefficient were used to analyse significant differences and association between variables with sector class and depth of vertical impaction, respectively. Logistic regression analysis determined radiographic parameters as predictors of palatal impaction. Results: Significant differences were seen between sector class, depth of vertical impaction and the radiographic parameters between cases and controls ( P ⩽ 0.001). For cases, strong correlation was found for angle C between the impacted canine and occlusal plane (r = −0.28, P = 0.022) and perpendicular distance D of impacted canine to the occlusal plane (r = 0.81, P ⩽ 0.001) with the depth of vertical impaction. Logistic regression analysis showed the odds of canine impaction increase with an increase in angle B and angle C. Conclusions: Our study showed that greater depth of vertical impaction, sector class, increased perpendicular distance and reduced angulation from occlusal plane resulted in palatal impaction of permanent maxillary canines. The odds of palatal canine impaction increase nearly twofold with every 10 increase in angle B and angle C.
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Affiliation(s)
- Durr e Shahwar Malik
- Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Mubassar Fida
- Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Rashna Hoshang Sukhia
- Section of Dentistry, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Authors' response. Am J Orthod Dentofacial Orthop 2018; 154:750-754. [DOI: 10.1016/j.ajodo.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 11/23/2022]
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40
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41
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Do we need CBCTs for sufficient diagnostics?-dentist-related factors. Int J Implant Dent 2018; 4:37. [PMID: 30443865 PMCID: PMC6238012 DOI: 10.1186/s40729-018-0147-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/08/2018] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to assess the diagnostic accuracy of various dentoalveolar pathologies based on panoramic radiography (OPG), cone beam computed tomography (CBCT) and printed 3D models in consecutive order; and to evaluate the impact of specialisation of residents in oral surgery (OS) versus residents in orthodontics (ORTH). Methods Fourteen residents were recruited to evaluate nine selected cases with different dentoalveolar pathologies. The residents were given for each case an OPG, a CBCT and a printed 3D model. For each case and imaging modality, the residents were asked several questions relating to (i) diagnosis, and (ii) the request for consecutive imaging in order to enable treatment. Further, aspects like impact of specialisation (OS versus ORTH), gender and years of experience were analysed. Results In this study, diagnostic accuracy (i) improved for OS from OPG to CBCT (OPG 66.3%, CBCT 83.4%) and likewise for ORTH (OPG 63.7%, CBCT 78.0%). 3D models generally did not seem more useful than CBCTs. For treatment planning (ii), residents in orthodontics considered OPGs significantly more often as sufficient compared to residents in oral surgery (OR 6.3, p < 0.001). Further, the odds to request a CBCT after OPG for treatment planning is influenced by dentist-related factors: female dentists (OR 3.8) or residents with limited professional experience as dentists (OR 3.0) asked more frequently for a CBCT. Conclusions Overall diagnostic accuracy is decent with OPG and can be improved with CBCT. Specialisation seems to have a moderate impact on diagnostic accuracy, but influences whether a CBCT was requested for treatment planning. Based on these findings, future studies shall analyse the diagnostic accuracy of specific pathologies in higher number in order to substantiate the present findings with regard to specific pathologies.
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42
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Yeh JK, Chen CH. Estimated radiation risk of cancer from dental cone-beam computed tomography imaging in orthodontics patients. BMC Oral Health 2018; 18:131. [PMID: 30075771 PMCID: PMC6091080 DOI: 10.1186/s12903-018-0592-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 07/16/2018] [Indexed: 12/03/2022] Open
Abstract
Background Radiation dose evaluation is important to cone-beam computed tomography (CBCT) for routine orthodontic treatment planning, especially for a significant proportion of children in orthodontic patients. This study evaluated the patient radiation dose and estimated the radiation cancer risk on dental CBCT according to the calculations by the Monte Carlo simulation method. Methods The dental CBCT scanner evaluated in this project was the i- CAT® (Imaging Sciences International Inc., PA, U.S.A.) device. Organ doses and effective doses were calculated by using personal computer-based Monte Carlo simulation (PCXMC 2.0 Rotation) software. The cancer risk resulting from the exposure to ionizing radiation was estimated by using the BEIR VII (Biologic Effects of Ionizing Radiation VII) report model, and the risk of exposure-induced death (REID) was assessed by PCXMC 2.0 Rotation software. Results The largest contribution to the organ dose and effective dose at Zref 83 cm positioned in the dental CBCT x-ray beam centerline was from the salivary glands (738.29μGy, 7.38 μSv). The different organ doses showed the maximum values at the different Zref locations, and the largest contribution to the organ dose and effective dose of all simulated positions was from the thyroid (928.77μGy, 37.5 μSv). The REID values in the 10-year olds (22.6 × 10− 7, female; 19 × 10− 7, male) were approximately double than those in 30-year olds (10.4 × 10− 7, female; 8.88 × 10− 7, male) for all cancers. The highest change during age range from 10 to 30 was shown in breast cancer of females. Conclusions Although individual cancer risk estimates as a function of gender and age are small, the concern about the risks from dental CBCT is related to the rapid increase in its use for orthodontic practice, especially in children patients.
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Affiliation(s)
- Jih-Kuei Yeh
- Division of Family Medicine, Kaohsiung Municipal United Hospital, No.976, Jhonghua 1st Rd., Gushan Dist, Kaohsiung City, 804, Taiwan
| | - Chia-Hui Chen
- Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, No.666, Buzih Road, Beitun District, Taichung City, 40601, Taiwan. .,College of Photonics National Chiao Tung University, No.301, Gaofa 3rd Rd., Guiren Dist, Tainan City, 711, Taiwan.
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Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. Am J Orthod Dentofacial Orthop 2018; 154:15-25. [DOI: 10.1016/j.ajodo.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 10/28/2022]
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Lombardo L, Arreghini A, Guarneri MP, Lauritano D, Nardone M, Siciliani G. Unexpected artefacts and occult pathologies under CBCT. ORAL & IMPLANTOLOGY 2018; 10:97-104. [PMID: 29876034 DOI: 10.11138/orl/2017.10.2.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose To present the most frequent occult pathologies unexpectedly encountered via cone-beam computed tomography (CBCT), with particular reference to the diagnostic role of the dentist and that of the radiographer, with a view to clarifying where the diagnostic responsibility lies. Material and methods A narrative literature review on the most diffused occult pathologies under CBCT was conducted, with iconographical guide as an example for each category. Results The most frequent forms of unexpected pathologies encountered are: the presence of foreign bodies, airway anomaly, and the presence of radio-opacity or -transparency in the maxillofacial district. Conclusions The orthodontists must know that they are responsible to recognize these frequent, and potentially serious, pathologies of the head and neck. If the dentist feels unable to take on this responsibility, he or she should, however, be sure to have the scans read by a specialist radiologist.
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Affiliation(s)
- L Lombardo
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - A Arreghini
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - M P Guarneri
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
| | - D Lauritano
- Department of Translational Medicine and Surgery, Neuroscience Center of Milan, University of Milano Bicocca, Monza, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - G Siciliani
- Department of Orthodontics, University of Ferrara, Ferrara, Italy
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Abstract
Orthodontists treat malocclusions by applying three-dimensional forces. For years, the diagnosis of this three-dimensional condition and the related treatment plan has been based on two-dimensional imaging. Lateral and anteroposterior cephalometric, panoramic, and periapical radiographs are some of the two-dimensional radiographs routinely used in orthodontics. Despite being highly beneficial in evaluating skeletal and dental relations, these radiographs fail to provide sufficient two-dimensional information in certain cases. The purpose of this compilation is to review the use of cone-beam computed tomography in orthodontics.
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Affiliation(s)
| | - Burçak Kaya
- Department of Orthodontics, Başkent University School of Dentistry, Ankara, Turkey
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46
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Schubert M, Proff P, Kirschneck C. Improved eruption path quantification and treatment time prognosis in alignment of impacted maxillary canines using CBCT imaging. Eur J Orthod 2018; 40:597-607. [DOI: 10.1093/ejo/cjy028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Michael Schubert
- Department of Orthodontics, University Medical Centre of Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Medical Centre of Regensburg, Germany
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47
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Precision and reliability of Dolphin 3-dimensional voxel-based superimposition. Am J Orthod Dentofacial Orthop 2018; 153:599-606. [DOI: 10.1016/j.ajodo.2017.07.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/01/2017] [Accepted: 07/01/2017] [Indexed: 11/19/2022]
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Zeno KG, Ghafari JG. Palatally impacted canines: A new 3-dimensional assessment of severity based on treatment objective. Am J Orthod Dentofacial Orthop 2018; 153:387-395. [DOI: 10.1016/j.ajodo.2017.07.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/01/2017] [Accepted: 07/01/2017] [Indexed: 11/15/2022]
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Tsolakis AI, Kalavritinos M, Bitsanis E, Sanoudos M, Benetou V, Alexiou K, Tsiklakis K. Reliability of different radiographic methods for the localization of displaced maxillary canines. Am J Orthod Dentofacial Orthop 2018; 153:308-314. [PMID: 29407509 DOI: 10.1016/j.ajodo.2017.06.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate the reliability of the radiographic images of the main conventional x-ray techniques compared with the information from cone-beam computed tomography (CBCT). METHODS Twenty patients with unilateral or bilateral impaction of the maxillary canines had radiographic examinations by means of periapical x-rays, occlusal x-rays, panoramic x-rays, and CBCT scans. Three experienced orthodontists examined all x-rays from each patient and evaluated the radiographic images of the impacted canines. The examiners were asked to detect resorption in adjacent teeth and the buccal-palatal position of the impacted canines. Agreement between examiners was statistically tested. RESULTS Different diagnoses were produced by the 3 examiners regarding localization of the impacted canines and the presence or absence of root resorption of the adjacent teeth in conventional radiographic images. It appears that whereas panoramic x-ray is more sensitive in detecting resorption and tooth position, occlusal and periapical imaging have higher specificity and positive predictive value. The examiners were in good or excellent agreement when occlusal and periapicals were used for the definite diagnosis of resorption and tooth position. There was no disagreement of the examiners in CBCT images, which were used as the gold standard. CONCLUSIONS Conventional radiographic methods demonstrated a more subjective diagnostic procedure compared with CBCT images. CBCT is a more accurate and precise examination method compared with conventional radiography for the localization of impacted teeth and root resorption of the adjacent teeth.
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Affiliation(s)
- Apostolos I Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Michael Kalavritinos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Elias Bitsanis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mattheos Sanoudos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Benetou
- Department of Epidemiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Alexiou
- Department of Oral and Maxillofacial Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsiklakis
- Department of Oral and Maxillofacial Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Kadesjö N, Lynds R, Nilsson M, Shi XQ. Radiation dose from X-ray examinations of impacted canines: cone beam CT vs two-dimensional imaging. Dentomaxillofac Radiol 2018; 47:20170305. [PMID: 29303367 PMCID: PMC6047634 DOI: 10.1259/dmfr.20170305] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 12/21/2017] [Accepted: 12/27/2017] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES To compare the radiation dose to children examined for impacted canines, using two-dimensional (2D) examinations (panoramic and periapical radiographs) and cone beam CT (CBCT). METHODS Organ doses were determined using an anthropomorphic 10-year-old child phantom. Two CBCT devices, a ProMax3D and a NewTom5G, were examined using thermoluminescent dosimeters. For the panoramic radiograph, a Promax device was used and for periapical radiographs, a Prostyle device with a ProSensor digital sensor was used. Both the panoramic and the intraoral devices were examined using Gafchromic-QR2 dosimetric film placed between the phantom slices. RESULTS ProMax3D and NewTom5G resulted in an effective dose of 88 µSv and 170 µSv respectively. A panoramic radiograph resulted in an effective dose of 4.1 µSv, while a periapical radiograph resulted in an effective dose of 0.6 µSv and 0.7 µSv using a maxillary lateral projection and central maxillary incisor projection respectively. CONCLUSIONS The effective dose from CBCT ranged from 140 times higher dose (NewTom5G compared to two periapical radiographs) to 15 times higher dose (ProMax3D compared to three periapical and one panoramic radiograph) than a 2D examination.
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Affiliation(s)
| | | | - Mats Nilsson
- Medical Radiation Physics, Skåne University Hospital, Malmö, Sweden
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