Comparative analysis of traditional radiographs and cone-beam computed tomography volumetric images in the diagnosis and treatment planning of maxillary impacted canines.
BACKGROUND
In this prospective study, we compared differences in the diagnosis and treatment planning of impacted maxillary canines between 2 imaging modalities.


METHODS
Twenty-five consecutive impacted maxillary canines were identified from the pool of patients seeking orthodontic treatment. The first set of radiographs consisted of traditional 2-dimensional (2D) images including panoramic, occlusal, and 2 periapical radiographs. The second set comprised prints of 3-dimensional (3D) volumetric dentition images obtained from a cone-beam computed tomography (CBCT) scan. Seven faculty member completed a questionnaire for every impacted canine and diagnostic radiographic modality (2D and 3D).


RESULTS
The data show that the judges produced different decisions regarding localization depending on the x-ray method. There were 21% disagreement (or discordance) in the perceived mesiodistal cusp tip position and 16% difference in the perceived labiopalatal position. In the perception of root resorption of adjacent teeth, there was 36% lack of congruence. Twenty-seven percent of the teeth that were planned to be left, recovered, or extracted with the 2D radiographs had different treatment plans when the judges viewed the 3D CBCT images (McNemar test, chi-square, 4.45; P = 0.035). The clinicians' confidence of the accuracy of diagnosis and treatment plan was statistically higher for CBCT images (P <0.001).


CONCLUSIONS
These results showed that 2D and 3D images of impacted maxillary canines can produce different diagnoses and treatment plans.
Haney
Eric
E
Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, Calif, USA.
Gansky
Stuart A
SA
Lee
Janice S
JS
Johnson
Earl
E
Maki
Koutaro
K
Miller
Arthur J
AJ
Huang
John C
JC
D000293:Adolescent; D000328:Adult; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data; D003481:Cuspid / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging*; D015588:Observer Variation; D010347:Patient Care Planning; D011446:Prospective Studies; D016300:Radiography, Bitewing / Q000706:statistics & numerical data; D011861:Radiography, Dental / Q000706:statistics & numerical data; D011862:Radiography, Panoramic / Q000706:statistics & numerical data; D012391:Root Resorption / Q000000981:diagnostic imaging; D019228:Tooth Crown / Q000000981:diagnostic imaging; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014087:Tooth Movement Techniques / Q000706:statistics & numerical data; D014095:Tooth, Impacted / Q000000981:diagnostic imaging*; D055815:Young Adult