Palatally impacted canines: A new 3-dimensional assessment of severity based on treatment objective

• Published in: American journal of orthodontics and dentofacial orthopedics 2018-03, Vol.153 (3), p.387-395
• Main Authors: Zeno, Kinan G., Ghafari, Joseph G.
• Format: Article
• Language: English
• Subjects: Adolescent; Cone-Beam Computed Tomography - methods; Cuspid; Dentistry; Female; Humans; Imaging, Three-Dimensional; Lebanon; Male; Palate, Hard; Retrospective Studies; Severity of Illness Index; Tooth, Impacted - diagnostic imaging; Tooth, Impacted - pathology
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2017.07.020

The severity of a palatally impacted canine (PIC) is gauged radiographically on 2-dimensional and 3-dimensional positional components: eg, angulation and height. We hypothesized that the position of a PIC relative to its virtual alignment in the arch is a better indication of impaction severity and treatment requirements. The aims of this research were to evaluate variations in PIC location on 3-dimensional images and to determine positional components associated with impaction severity. Linear and angular measurements of 38 PICs from 28 cone-beam computed tomography scans were made on the panoramic, coronal, sagittal, and axial sections. Measurements included angulation of the PIC to the virtually aligned canine, midline, and palatal plane; and distances between cusp tip and apex to various reference planes—eg, occlusal and midpalatal. Statistical assessments comprised t tests for group comparisons based on PIC and virtually aligned canine severity (cutoff at 30°) and Pearson product moment correlations for associations among variables. Angulations of the PIC to the virtually aligned canine were 32.5° ± 15.5° (range, 9°-59°) and 19.6° ± 6.9° and 45.37° ± 9.6°, respectively, in the less severe and more severe groups (P