Original article
Early prediction of maxillary canine impaction from panoramic radiographs

https://doi.org/10.1016/j.ajodo.2012.02.021Get rights and content

Introduction

Treatment of impacted maxillary canines frequently requires surgical intervention, which can involve substantial complications. Thus, it is desirable to identify a reliable method for the early diagnosis of canine displacement. In this study, we sought to determine whether impaction of a maxillary canine can be predicted using measurements made on a panoramic radiograph.

Methods

This retrospective study was conducted at a dental hospital in Hong Kong with panoramic radiographs. Geometric measurements were made on 384 panoramic radiographs of patients with a unilaterally impacted maxillary canine (group I) to characterize its presentation and compare them with the unaffected antimere (group II).

Results

There was a clinically discernible difference of 4 mm at the age of 8 years and beyond between the mean distance of the tip of the impacted canine (group I) and that of the antimere (group II) from the occlusal plane (P <0.05). Furthermore, there was a statistically significant difference at the age of 9 years and beyond between the 2 groups according to the position in different sectors and according to the mean angle made with the midline (P <0.05).

Conclusions

Diagnosis of maxillary canine impaction is possible at 8 years of age by using geometric measurements on panoramic radiographs.

Section snippets

Material and methods

A total of 384 panoramic radiographs of 442 nonsyndromic patients known to have unilaterally impacted maxillary canines who had attended the Paediatric Dentistry and Orthodontics Clinic at Prince Philip Dental Hospital in Hong Kong SAR, China, were available for assessment. The clinical records and the radiologic data were used to assess and confirm the position of an impacted maxillary canine. The canine was defined as impacted if its antimere had completely erupted in the oral cavity, but the

Results

The 384 panoramic radiographs that formed the sample for this study included parts of records from 111 patients with a total of 222 longitudinal follow-up radiographs. The data obtained from all 384 panoramic radiographs were divided into different age groups (Table I) to facilitate comparing the position of the impacted canine (group I) with the unaffected antimere (group II). This included 54 radiographs from patients in the age group of 3 to 8 years. No statistically significant difference

Discussion

Panoramic films have been used extensively for the identification of diagnostic parameters aimed at facilitating interceptive treatment planning. Occasionally, patients have distortions in the frontal dentoalveolar regions.1, 10 However, it has been demonstrated by mathematical calculations and confirmed by experimental tests that panoramic radiographic images can be reliable for geometric measurements in clinical practice.11, 12 Linear vertical measurements, ratio calculations, and angular

Conclusions

The vertical distance of the tip of the maxillary canine from the occlusal plane as evident on a panoramic radiograph is a good predictor of impaction of a maxillary canine. Diagnosis of an impacted maxillary canine can be made after 8 years of age, especially if the angulation of the canine with the midline is also considered. Hence, screening of patients to detect an early impaction could be performed at this age.

References (21)

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    Recently, researchers tried to figure out possible predictors of success and cut-off points to benefit from extraction of the deciduous canine using PAN and CBCT (cone beam computed tomography) [6,11]. Although prediction of successful eruption of PDC based on the position of the displaced maxillary canine has been described in several literatures [1–6,11–15], none of the published studies performed a systematic review and meta-analysis to investigate the quality of evidence and effectiveness of different predictive variables. The primary aim of this meta-analysis is to establish which possible predictors based on position of displaced canines identified in a panoramic radiograph would facilitate the eruption of PDC, when considering interceptive extraction of primary canines in late mixed dentition.

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The authors report no commercial, proprietary, or financial interest in the products or companies described in this article.

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