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Peralta-Mamani M, Rubira CMF, López-López J, Honório HM, Rubira-Bullen IRF. CBCT vs panoramic radiography in assessment of impacted upper canine and root resorption of the adjacent teeth: A systematic review and meta-analysis. J Clin Exp Dent 2024; 16:e198-e222. [PMID: 38496811 PMCID: PMC10943682 DOI: 10.4317/jced.61285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 03/19/2024] Open
Abstract
Background The IC may cause reabsorption of adjacent teeth; therefore detailed assessment of its position would enhance decision-making in the clinical workflow. The objective was to compare cone-beam computed tomography (CBCT) and panoramic radiography (PR) in assessing the position of the impacted upper canine (IC) and root resorption of adjacent teeth. Material and Methods Pubmed, EMBASE, Science Direct, Web of Science, and SCOPUS databases were searched for studies published before August 2023. Studies that evaluated IC by using both imaging methods were included. For statistical analysis, the Comprehensive Meta-Analysis software (Biostat; Englewood, NJ) was used, p≤0.05. Results A total of 17 articles were included, with 877 patients (average age of 17.6 years) and 1,115 ICs. The most frequent mesio-distal location of the IC was in sectors 3 and 4. The meta-analysis was performed with eleven studies. CBCT was more accurate in determining the labio-palatal position compared with PR (p<0.001) (CI 95%; 60% in labial position, 0.254-0.542, OR:0.398; 56% in palatal position, 0.350-0.533, OR:0.441; 78% in mid-alveolus position, 0.188-0.234, OR:0.221). For IC angulation to the midline, CBCT showing a smaller and more accurate angle than PR (p<0.001) (CI 95%, 18.008-33.686). IC angulation to the occlusal plane and lateral incisor, there was smaller angle in PR compared to CBCT (p<0.001) (CI 95%, 51.292-65.934; CI 95%, 30.011-55.954). With PR, fewer cases of root resorption of teeth adjacent to the IC were visualized compared with CBCT (86% less) (p<0.001) (CI 95%, 0.089-0.186; OR value: 0.138; n=1049). Conclusions CBCT showed statistically significant differences compared to PR in the assessment of IC position and root resorption of adjacent teeth. CBCT provided clinically relevant information that may contribute to diagnosing and planning IC treatment when PR was not sufficient. Key words:Canine teeth, tooth, impacted, panoramic radiography, Cone-beam computed tomography, systematic review, meta-analysis.
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Affiliation(s)
- Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo. Alameda Octávio Pinheiro Brisola, 9-75, Vila Universitária, ZIP CODE: 17012-901, Bauru- SP, Brazil
| | - Cássia-Maria-Fischer Rubira
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo. Alameda Octávio Pinheiro Brisola, 9-75, Vila Universitária, ZIP CODE: 17012-901, Bauru- SP, Brazil
| | - José López-López
- Oral Health and Masticatory System Group-IDIBELL / Faculty of Medicine and Health Sciences (School of Dentistry) / Odontological Hospital University of Barcelona, University of Barcelona, Campus Bellvitge, Carrer de la Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Heitor-Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo. Alameda Octávio Pinheiro Brisola, 9-75, Vila Universitária, ZIP CODE: 17012-901, Bauru- SP, Brazil
| | - Izabel-Regina-Fischer Rubira-Bullen
- Department of Surgery, Stomatology, Pathology and Radiology - Bauru School of Dentistry, University of São Paulo. Alameda Octávio Pinheiro Brisola, 9-75, Vila Universitária, ZIP CODE: 17012-901, Bauru- SP, Brazil
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Dinu Ş, Todor L, Zetu IN, Păcurar M, Porumb A, Milutinovici RA, Popovici RA, Brad S, Sink BA, Popa M. Radiographic methods for locating impacted maxillary canines. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:599-606. [PMID: 36808194 PMCID: PMC10026925 DOI: 10.47162/rjme.63.4.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Maxillary canine impaction is a fairly common phenomenon in dental practice. Most studies indicate its palatal position. For a successful orthodontic and∕or surgical therapy, it is necessary to correctly identify the impacted canine in the depth of the maxillary bone, using conventional and digital radiological investigations, each with their advantages and disadvantages. Dental practitioners must indicate the most "targeted" radiological investigation. This paper aims to review the various radiographic techniques available for determining the location of the impacted maxillary canine.
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Affiliation(s)
- Ştefania Dinu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Romania; ; Department of Orthodontics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania;
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Gunardi OJ, Danudiningrat CP, Rizqiawan A, Mulyawan I, Amir MS, Kamadjaja DB, Sumarta NPM, Anugraha G, Fessi RA, Barus L, Ono S. Decision-Making Criteria of Odontectomy or Surgical Exposure in Impacted Maxillary Canine Based on Treatment Difficulty Index Modification. Eur J Dent 2022; 16:796-802. [PMID: 35016233 DOI: 10.1055/s-0041-1739447] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Canine impaction is a difficult condition to treat, and it usually necessitates a combination of surgical exposure and orthodontic traction or surgical extraction. An accurate assessment of the maxillary canine's position can help determine the severity of the impaction, the difficulty of therapy, and the treatment's prognosis. MATERIALS AND METHODS A total of 55 impacted canines were studied and selected retrospectively. Difficulty indexes were used to measure the severity of impaction with pretreatment panoramic radiographs. STATISTICAL ANALYSIS Pearson correlation was used to test the validity of the difficulty index modification score. Regression statistical analysis was used to evaluate any correlation between total scoring from each index with surgical treatment. RESULTS The validity test on the variable modification index score showed a valid value (p = 0.000). According to both treatment difficulty and modification index, odontectomy group showed higher mean of total scoring than surgical exposure group. Treatment difficulty and modification index showed a significant correlation with surgical treatment (p = 0.003 and p = 0.001). CONCLUSIONS The higher the severity of canine impaction, the greater is the possibility of odontectomy than surgical exposure. Both indexes can consider to be used in determining surgical treatment planning.
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Affiliation(s)
- Olivia Jennifer Gunardi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Coen Pramono Danudiningrat
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Andra Rizqiawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Indra Mulyawan
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Muhammad Subhan Amir
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - David Buntoro Kamadjaja
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ni Putu Mira Sumarta
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ganendra Anugraha
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Reza Al Fessi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Liska Barus
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School and Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Immediate Post-Extraction Short Implant Placement with Immediate Loading and without Extraction of an Impacted Maxillary Canine: Two Case Reports. MATERIALS 2021; 14:ma14112757. [PMID: 34071018 PMCID: PMC8197076 DOI: 10.3390/ma14112757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
For the treatment of impacted maxillary canines, traction associated with a complete orthodontic treatment is the first choice in young patients. However, in adults, this treatment has a worse prognosis. The surgical extraction of the impacted tooth can result in a series of complications and a compromised alveolar bone integrity, which may lead to the requirement of a bone regeneration/grafting procedure to replace the canine with a dental implant. These case reports aimed to describe an alternative treatment procedure to the surgical extraction of impacted maxillary canines in adults. Following clinical and computerized tomography-scan (CT-Scan) examination, the possibility of maintaining the impacted canine in its position and replacing the temporary canine present in its place with a dental implant was planned. A short dental implant with an immediate provisional crown was placed, without contacting the impacted canine. At 3 months follow-up, a definitive metal-ceramic restoration was placed. Follow-up visits were performed periodically. The implant site showed a physiological soft tissue color and firmness, no marginal bone loss, no infection or inflammation, and an adequate aesthetic result in all follow-up visits. These results suggest that the treatment carried out is a valid option to rehabilitate with an osseointegrated short implant area where a canine is included, as long as there is a sufficient amount of the remaining bone.
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Grisar K, Denoiseaux B, Martin C, Hoppenreijs T, Calburean F, Politis C, Jacobs R. Treatment for critically impacted maxillary canines: Clinical versus scientific evidence - A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e12-e19. [PMID: 33862266 DOI: 10.1016/j.jormas.2021.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/21/2021] [Accepted: 03/25/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Critically impacted maxillary canines are prone to fail to respond to conventional surgical exposure and orthodontic traction. Correct identification of a critical impaction requires enhanced diagnosis modalities and might lead to incorporating alternative surgical strategies in the treatment plan. Predictability of techniques such as apicotomy or tooth autotransplantation is, however, yet to be determined. The objective of this study was to systematically review treatment perspectives for critically impacted maxillary canines. METHODS A systematic review of the available literature until april 2020 was conducted using an electronic search in Embase, Cochrane Central, Web of Science and PubMed databases. Randomised and non-randomised studies investigating treatment options and treatment outcome for buccally and/or palatally critically impacted maxillary canines were considered for the review. Information recorded concerned study design and setting, participants' characteristics and details regarding the type of intervention, types of outcomes measured and follow-up time. The included studies received a methodological quality scoring and risk of bias analysis according to a tool suggested by Murad et al (2018). RESULTS Five studies were included in the quality analysis, all case series. The included studies enrolled a total of 302 patients and counted 346 critical maxillary canine impactions. Apicotomy and autotransplantation were listed as potential surgical approaches with surgical outcome presented for both surgical strategies. Adequate esthetical and/or functional outcomes were reported in most of the included studies. According to the quality assessment tool used, the reviewed studies scored medium on the proposed scale. DISCUSSION Literature featuring protocols for identifying and treating critical maxillary canine impaction only consists of case series and case reports, which provide low level of evidence. The rather good results reported by the reviewed studies must be put into perspective as the methodology of these studies was insufficient and potential bias was identified. Comprehensive clinical research is needed to further investigate treatment options and form a basis for clinical guidelines.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - Benjamin Denoiseaux
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Catalina Martin
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Theo Hoppenreijs
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem
| | - Flavia Calburean
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University Leuven, Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Kapetanović A, Oosterkamp BCM, Lamberts AA, Schols JGJH. Orthodontic radiology: development of a clinical practice guideline. LA RADIOLOGIA MEDICA 2021; 126:72-82. [PMID: 32462471 PMCID: PMC7870627 DOI: 10.1007/s11547-020-01219-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Radiographs are considered essential in orthodontics. However, their diagnostic value and indications for use are still uncertain, while exposure to radiation carries health risks. This study aimed to report on the development of a clinical practice guideline on orthodontic radiology. METHODS A Guideline Development Taskforce was set up. The GRADE methodology was used for development and the RIGHT Statement for reporting of the guideline. We systematically reviewed articles to address the main clinical question: how different types of radiographs contribute to orthodontic diagnosis, treatment planning and post-treatment outcome evaluation. After a literature search and data extraction, we formulated conclusions and assessed the strength of the evidence according to the GRADE method. Both literature conclusions and the most important considerations, such as patient preferences, organizational matters and expert opinions were taken into account to finally issue recommendations. RESULTS 7 clinical questions focused on orthopantomograms, lateral cephalograms, hand-wrist radiographs, peri-apical radiographs, bitewings, antero-occlusal radiographs, and cone-beam computer tomographic imaging. The literature search lead to 484 unique studies, of which 17 were included in the analysis. The strength of evidence of the conclusions was graded low or very low. We formulated considerations and took them into account when issuing the 13 clinical recommendations to address the clinical questions. CONCLUSIONS There was a considerable lack of scientific evidence on this topic. Nonetheless, this guideline provides clinicians with a tool for decision-making regarding radiographic records while enhancing patient radiation protection. More research of higher quality is recommended for a future update.
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Affiliation(s)
- Aldin Kapetanović
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Barbara C M Oosterkamp
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Antoon A Lamberts
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
| | - Jan G J H Schols
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
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Mohammed AK, Sravani G, Vallappareddy D, Rao AR, Qureshi A, Prasad AN. Localization of Impacted Canines - A Comparative Study of Computed Tomography and Orthopantomography. J Med Life 2020; 13:56-63. [PMID: 32341702 PMCID: PMC7175446 DOI: 10.25122/jml-2020-0001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Our aim was to evaluate the location of impacted canines and their proximity to the lateral and central incisor to assess the prognosis of the impacted canine and compare the reliability of 2D versus 3D imaging solutions. We carried a prospective study on 17 subjects with impacted maxillary canines. Later, the patients underwent radiologic examination, i.e., sectional computed tomography and orthopantomography. The obtained records were compared regarding the location of the impacted maxillary canine, the proximity and resorption of the impacted canine to the lateral and central incisors, the prognosis of the impacted canine, and the linear distance of the canine from the vertical and horizontal reference lines drawn. Eleven males (45.8%) and 13 females (54.1%), 11 (45.8%) impacted canines on the right side, and 13 (54.1%) on the left side, as well as 2 (8.3%) transpositions, were noted. Buccally impacted teeth caused less resorption of the adjacent teeth. Among the 24 teeth examined using orthopantomography with the sector method, 3 (12.5%) teeth were found in sector 1. There were 8 (33.33%) teeth in sector 2, and 11 (45.8%) of the impacted canines were in sector 3. In localizing impacted maxillary canines, computed tomography revealed an increased accuracy of 31% compared to orthopantomography. Even though both computed tomography and orthopantomography revealed similar records, computed tomography showed more accuracy, also having an added advantage of its 3D viewing capabilities in precise localization of the impacted maxillary canine.
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Affiliation(s)
| | - Garepally Sravani
- Department Of Orthodontics, Sri Balaji Dental College, Hyderabad, Telangana, India
| | - Deepti Vallappareddy
- Department Of Orthodontics, Sri Sai College Of Dental Surgery, Vikarabad. Telangana, India
| | - Annamaneni Rakesh Rao
- Department Of Orthodontics, Sri Sai College Of Dental Surgery, Vikarabad. Telangana, India
| | - Arshad Qureshi
- Department Of Orthodontics, Sri Sai College Of Dental Surgery, Vikarabad. Telangana, India
| | - Anisha N Prasad
- Department Of Orthodontics, Sri Balaji Dental College, Hyderabad, Telangana, India
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Amintavakoli N, Spivakovsky S. Cone-beam computed tomography or conventional radiography for localising of maxillary impacted canines? Evid Based Dent 2018; 19:22-23. [PMID: 29568018 DOI: 10.1038/sj.ebd.6401291] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Data sourcesPubMed, Web of Science, CINHAL and the Cochrane Library were searched until May 2016. Unpublished data were searched in Pro-Quest Dissertation, Abstracts and Thesis and Google Scholar, supplemented with manual search of the included studies references. No language restriction was used.Study selectionAll types of study designs were included, except case reports, comparing CBCT data with conventional radiographs. The primary outcome was: diagnostic accuracy between modalities, agreement in position, treatment planning and outcome efficacy. The secondary outcome was intermodality agreement in lateral root resorption detection and intra and inter-observer agreement values.Data extraction and synthesisTwo reviewers independently selected the studies for inclusion, performed data extraction and evaluated risk of bias. Discrepancies were resolved by discussions and reaching consensus. The Newcastle-Ottawa Scale was used to assess the risk of bias for case-controlled and cohort studies and a modified version for cross-sectional studies. The Quality Assessment of Diagnostic Accuracy (QUADAS-2) tool was used to rate diagnostic accuracy studies.ResultsEight studies met the inclusion criteria, two on diagnostic accuracy. The remaining six included 292 impacted canines in 224 patients. Outcomes were presented as calculated level of agreement and statistical significance for each primary outcome reported. Based on the diagnostic accuracy of two in vitro studies, the CBCT accuracy ranged from 50% to 95% while for conventional radiographs it ranged from 39% to 85%.The other six studies reported inter-modalities agreement in localisation (six studies) and treatment planning agreement (three studies). The inter-modalities agreement varied from 0.20 to 0.82, with observed agreement of 64% to 84% in localisation of canine. The treatment planning agreement varied from 0.36 to 0.72.ConclusionsThe authors concluded that CBCT is more accurate than conventional radiographs in localising maxillary impacted canines and there is a broad range of inter-observer and modalities agreement for location and treatment planning. There is no robust evidence to support using CBCT as first line imaging method.
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