Evaluation of Impacted Canines Utilizing Three Radiographic Methods in Orthodontic Patients in Benin City, Nigeria

Abstract

Background: Impacted canines are one of the most commonly missing teeth in the oral cavity and traditionally, two dimensional (2-D) radiographic views  have been utilized in localizing such teeth. The introduction of the 3-D Cone Beam Computed Tomography was to enable localization in three dimensions. A reliable and concise radiographic technique will enable proper diagnosis of the type and extent of impaction and aid in choosing the  proper treatment and also monitor treatment progression.

Aim: The aim of this study was to evaluate impacted canines in orthodontic patients utilizing three radiographic methods in Benin City, Nigeria.

Methods: In this prospective study, 34 pre-orthodontic patients (30 with unilateral and 4 with bilateral impactions) and a total number of 38 impacted  canines were selected. The Lateral Cephalometric radiograph was used to determine the patients’ orthodontic problem. Three groups of participants  were selected and identified based on the radiographic method utilized; with group 1, the periapical / Occlusal group (POCC, n=13); group 2, the  Orthopantomogram group (OPG, n=13). The third group was the Cone Beam Computed Tomography group (CBCT, n=12). Impacted canines were  detected and the position assessed and classified utilizing three radiographic methods into classes I to VI. The differences between groups and  correlations between variables were determined with the student’s t-test and the Spearman correlation coefficient respectively. Significant values of  P<0.05 were applied.

Results: The mean age of participants was 18.29±6.15 years. A total number of 30(78.9%) impactions were seen in the upper jaw and 8(21.1%) in the  lower jaw. Bilateral impactions were seen in the upper jaw of 3(7.9%) patients and 1(2.6%) in the lower jaw respectively. The position of the canines could  only be identified clearly in classes I and II from group 1. Group 2 (OPG) was the least definite in identifying accurately the position of the canines. The  CBCT(Group 3) did not record any impaction in the lower jaw. Consecutive paraxial cuts at 1.5mm interval on the CBCT showed the position of the canines  to be in Class I in 6(50%), class II in 3(25%) and classes III in 2(16.7%) and VI in 1(8.3%) respectively in the upper jaw.

Conclusion: The CBCT  appears to be the most reliable method of identifying the position and depth of impacted canines.