Two- versus three-dimensional imaging in subjects with unerupted maxillary canines

• Published in: European journal of orthodontics Vol. 33; no. 4; pp. 344 - 349
• Main Authors: Botticelli, Susanna, Verna, Carlalberta, Cattaneo, Paolo M., Heidmann, Jens, Melsen, Birte
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.08.2011
• Subjects: Alveolar Process - diagnostic imaging; Bicuspid - diagnostic imaging; Cephalometry - methods; Child; Cone-Beam Computed Tomography - methods; Cuspid - diagnostic imaging; Decision Making; Dental Arch - diagnostic imaging; Female; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Incisor - diagnostic imaging; Male; Maxilla - diagnostic imaging; Patient Care Planning; Radiographic Image Enhancement - methods; Radiographic Magnification; Radiography, Bitewing - methods; Radiography, Dental, Digital - methods; Radiography, Panoramic - methods; Root Resorption - diagnostic imaging; Single-Blind Method; Tooth Eruption, Ectopic - diagnostic imaging; Tooth, Impacted - diagnostic imaging; Tooth, Unerupted - diagnostic imaging
• ISSN: 0141-5387; 1460-2210; 1460-2210
• DOI: 10.1093/ejo/cjq102

The aim of this study was to evaluate whether there is any difference in the diagnostic information provided by conventional two-dimensional (2D) images or by three-dimensional (3D) cone beam computed tomography (CBCT) in subjects with unerupted maxillary canines. Twenty-seven patients (17 females and 10 males, mean age 11.8 years) undergoing orthodontic treatment with 39 impacted or retained maxillary canines were included. For each canine, two different digital image sets were obtained: (1) A 2D image set including a panoramic radiograph, a lateral cephalogram, and the available periapical radiographs with different projections and (2) A 3D image set obtained with CBCT. Both sets of images were submitted, in a single-blind randomized order, to eight dentists. A questionnaire was used to assess the position of the canine, the presence of root resorption, the difficulty of the case, treatment choice options, and the quality of the images. Data analysis was performed using the McNemar-Bowker test for paired data, Kappa statistics, and paired t-tests. The findings demonstrated a difference in the localization of the impacted canines between the two techniques, which can be explained by factors affecting the conventional 2D radiographs such as distortion, magnification, and superimposition of anatomical structures situated in different planes of space. The increased precision in the localization of the canines and the improved estimation of the space conditions in the arch obtained with CBCT resulted in a difference in diagnosis and treatment planning towards a more clinically orientated approach.