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Evaluation of potency of panoramic radiography for estimating the position of maxillary impacted canines using 3D CT
Original Article

Korean J Orthod 2008;38(4):265-274.

Published online: 19 January 2008

DOI: https://doi.org/10.4041/kjod.2008.38.4.265

Evaluation of potency of panoramic radiography for estimating the position of maxillary impacted canines using 3D CT

Hye-Jung Kim, DDS, MSDa, Hyo-Sang Park, DDS, MSD, PhD,b, Oh-Won Kwon, DDS, MSD, PhDc

aResident, Department of Orthodontics, School of Dentistry, Kyungpook National University

bProfessor, Department of Orthodontics, School of Dentistry, Kyungpook National University

cProfessor, Department of Orthodontics, School of Dentistry, Kyungpook National University

Corresponding author: Hyo-Sang Park. Department of Orthodontics, School of Dentistry, Kyungpook National University, 50, Samdeok-dong 2-ga, Jung-gu, Daegu 700-721, Korea. +82 53 420 5941; e-mail, parkhs@knu.ac.kr.

Received 16 October 2006       Revised 22 May 2008       Accepted 25 May 2008

Copyright © 2008 The Korean Association of Orthodontists

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective:

The aim of this study was to evaluate the potency of panoramic radiography for the detection of maxillary impacted canines.

Methods:

Twenty-five patients were selected, comprised of 7 males (mean age: 10.9 years, range: 8.5 - 14.5 years) and 18 females (mean age: 10.9 years, range: 8.2 - 15.7 years). In total, thirty-five maxillary impacted canines were estimated. The position of the canine and root resorption of adjacent teeth were evaluated on panoramic radiography and 3D CT.

Results:

Except for angulation to the occlusal plane, the other parameters, such as tooth length, crown width, vertical distance and lateral shift showed larger values on panoramic radiography compared to 3D CT. In palatally impacted cases, the angulation of canine was smaller, and the vertical distance to the occlusal place was larger on panoramic radiography than 3D CT. For labially impacted canines, tooth length, crown width, and angulation to the occlusal plane were similar for the two methods. The sensitivity for detecting root resorption on panoramic radiography was calculated as being 33.3% of 3D CT.

Conclusions:

The position of labially impacted canines can be effectively estimated using panoramic radiography, but palatally impacted canines need further investigation such as 3D CT for proper diagnosis.

Keywords: Maxillary impacted canine, Panoramic radiography, 3D CT

REFERENCES

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Fig 1.
Panoramic measurements. A, tooth length; B, crown width; C, angulation related to the occlusal plane; D, vertical distance related to the occlusal plane; E, lateral shift related to the midsagittal plane.
kjod-38-265f1.tif
Fig 2.
Three dimensional reconstruction image of impacted canine from CT scanning.
kjod-38-265f2.tif
Fig 3.
Three dimensional segmented image of impacted canine.
kjod-38-265f3.tif
Fig 4.
Angular measurements at reconstructed image from CT scanning. A, Angulation of impacted canine to occlusal plane; B, angulation of impacted canine to midsagittal plane; C, angulation of impacted canine to coronal plane.
kjod-38-265f4.tif
Table 1.
Comparison of measurements between panoramic radiography and 3D CT using paired t-test
Variable Panoramic X-ray 3D CT p value
Mean±SD Mean±SD
Tooth length (mm) 24.76±3.64 22.54±2.04 0.0001
Crown width (mm) 9.74±0.97 9.05±0.86 0.0023
Angulation to occlusal plane (o) 48.70±19.26 53.53±16.32 0.0030
Vertical distance (mm) 16.47±4.46 11.41±4.01 0.0001
Lateral shift (mm) 8.37±4.92 7.42±3.98 0.0034

SD, standard deviation; statistically significant at p ＜ 0.05.

Table 2.
Differences in tooth length and crown width measurements according to angulation to occlusal plane for panoramic radiography (unit: mm)
Variable Mean±SD Min Max Correlation analysis of angulation on panoramic radiography Significance
ΔTooth length 2.21±2.76 -3.01 8.75 -0.18784 NS
ΔCrown width 0.69±1.24 -1.90 3.60 0.25441 NS

NS, not significant; Δtooth length, difference of tooth length;Δcrown width, difference of crown width between panoramic radiography and 3D CT; Min, minimum; Max, maximum.

Table 3.
Comparison of difference between tooth length, crown width, angulation, vertical distance and lateral shift on panoramic radiography and 3D CT according to position of canine impaction using paired t-test
Variable Labial impaction(n=24) Palatal impaction(n=11) p value
Mean±SD Mean±SD
ΔTooth length (mm) 2.22±2.71 2.18±3.04 0.9644
ΔCrown width (mm) 0.90±1.26 0.23±1.10 0.1344
ΔAngulation to occlusal plane (o) -1.78±6.77 -11.49±9.73 0.0017
ΔVertical distance(mm) 4.47±1.62 6.35±1.95 0.0052
ΔLateral shift (mm) 0.97±1.97 0.90±1.33 0.9217

Δtooth length,difference between tooth length on panoramic radiography and 3D CT; Δcrown width, difference between crown width on panoramic radiography and 3D CT;Δangulation to occlusal plane, difference between angulation on panoramic radiography and at 3D CT;Δvertical distance, difference between vertical distance on panoramic radiography and 3D CT; Δlateral shift,difference between lateral shift on panoramic radiography and 3D CT; statistically significant at p ＜ 0.05.

Table 4.
Comparison of root resorption detection rate between 3D CT and panoramic radiography according to impacted position (unit: case)
Root resorption area Labial impaction (n=18) Palatal impaction (n=9)
3DCT Panoramic radiography Panoramic detection rate(%) 3D CT Panoramic radiography Panoramic detection rate(%)
Buccal 9 2 22.2      
Disto-buccal 6 2 25.0      
Mesio-buccal 2 2 100.0      
Distal 2 1 50.0      
Disto-palatal 2 2 100.0 5 1 20.0
Mesial       1 0 0
Palatal       2 0 0
Apex       1 0 0
Table 5.
Magnification rate of panoramic radiography
Magnification rate Tooth length Crown width Angulation to occlusal plane Vertical distance Lateral shift
L P L P
Mean±SD 1.10±0.12 1.08±0.14 0.94±0.21 0.79±0.28 1.42±0.23 2.27±1.84 1.24±0.65

L, Labial impaction; P, palatal impaction.

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