Root resorption of maxillary lateral incisors associated with maxillary impacted canines: Cone-beam computed tomography and panoramic radiography study

Abstract

: The position of maxillary impacted canine (MIC) and the presence of lateral incisor root resorption (RR) remains a challenge for interceptive orthodontics and surgical treatment planning. The use of panoramic radiographs will be compared with CBCT in the diagnosis of RR and emphasize the importance of accurate diagnostic imaging.: To compare the diagnostic accuracy of Cone Beam Computed Tomography and Panoramic Radiography in detecting lateral incisor RR associated with MIC. To evaluate, with respect to sector position of impacted canines, the agreement between panoramic radiographs and CBCT in detecting lateral incisor RR.: A cross-sectional retrospective descriptive study on panoramic and CBCT radiographic records between January 2014 and December 2020. The study setting was Section of Diagnostic Imaging at a University Oral Health Centre. All patients requiring radiographs are referred to this section by all dental departments of the dental hospital. The study sample consisted of CBCT and panoramic images of impacted maxillary canines of patients older than 9yrs. Patients with odontogenic and non-odontogenic pathology in the canine and incisor area, those with previous diagnosis of external root resorption verified from the patient’s treatment records, and patients who have had any form of orthodontic treatment; removable or fixed appliances were excluded. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 27. Pearson's chi-squared test was used to analyse the agreement between panoramic radiographs and CBCT in locating canine sector position. All tests were conducted at 5% significance level. Fifty patients records were analysed in our study. The median age of the sample was 15 years and the IQR was 12.5-19. Our sample consisted predominantly of females (n=40) compared to males(n=10). A total of 65 MIC were assessed with 16 bilateral impactions (n=32) and the unilateral impactions (n=33). Of the 65 MICs, 46% were located on the right side and 54% were located on the left side. The CBCT examination showed that 58% (n = 38) of MIC were located palatally, 34% (n=22) labially and 8% (n=5) in the mid-alveolus (between the teeth). The majority of MIC occurred in sector 4 in 2-D pan (26%, n=17) and 3-D pan at (32%, n=21). Pearson's chi-squared test results showed a statistically significant difference in the agreement between 2-D pan and 3-D pan in locating canine sector position (p=0.001).: The detection of root resorption in our study underscores the importance for clinicians to examine panoramic radiographs thoroughly beyond the counting of teeth. Although panoramic radiographs are the routine diagnostic tool in contemporary dental practice, their limitation in definitive diagnosis of root resorption should be augmented with the use of CBCT.