European Orthodontic Society Annual Meeting location:Santiago de Compostela date:18-23 June 2012
OP 001 oral presentation
AIM: To compare surgical treatment planning for impacted maxillary canines between two-dimensional (2D) versus three-dimensional (3D) diagnostic radiographs, and to evaluate the influence of the imaging modality on treatment planning.
SUBJECTS AND METHOD: Thirty-two subjects (19 females, 13 males) with a mean age of 25 years (SD 14 years). In total, 39 impacted canines were referred for surgical intervention. Two sets of radiographic information were obtained. The first set was panoramic radiographs and the second 3D volumetric images obtained from a cone beam computed tomography (CBCT) scan. Both 2D and 3D pre-operative radiographic diagnostic sets were produced and subsequently analyzed by four orthodontists and two oral surgeons. Peri-operative evaluations were conducted by the treating surgeon. A short post-operative recall after one week was recorded.
RESULTS: The observers had a significantly higher level of confidence in their CBCT image-based therapy plans than the 2D radiograph-based plans (P < 0.001). The radiographically based diagnosis of type of impaction, canine crown position in the sagittal and axial planes, contact relationship, and lateral incisor root resorption were significantly different between the 2D versus 3D datasets. In contrast, pre- and perioperative evaluations were not significantly different when using 2D or 3D information. The use of 3D images resulted in extra diagnostic information compared to 2D in 31 per cent of the cases. The evaluation of this study recommended the use of CBCT in 61 per cent of the impacted canine cases. In 79 per cent of the evaluations, the observers changed the therapeutic approach based on 3D information.
CONCLUSION: CBCT is recommended for the surgical intervention in canine impaction. CBCT images are useful for optimal treatment planning in cases of canine impaction and root resorption of adjacent incisors.