Case Report: An association of the gubernacular canal, supernumerary tooth and odontoma with an impacted canine on cone-beam computed tomography

This report describes a clinical case of asymptomatic compound odontoma in the anterior left side of the maxilla associated with an impacted canine and supernumerary tooth with a gubernacular canal of a 47- year-old female with no relevant medical history. Cone-beam computed tomography (CBCT) was performed for precise three-dimensional localization of each structure and assessment of their spatial relationship with the associated structures before surgery. The treatment protocol involved surgical enucleation of the odontoma and open extraction of both impacted and supernumerary teeth. The patient had uneventful healing and proceeded with the prosthodontic treatment plan.

The dentist should be aware of the probability of a close relationship between the development of odontoma and presence of the gubernacular tract, which could be used as a future radiographic diagnostic criterion of an odontoma. Also, we recommend that more studies be performed in this field to deeply analyze the imaging characteristics of GT and its spatial association with various pathological lesions in the future.

Localization of Impacted Canines - A Comparative Study of Computed Tomography and Orthopantomography

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.