Diagnostic accuracy of conventional orthodontic radiographic modalities and cone-beam computed tomography for localization of impacted maxillary canine teeth

Background: Orthodontic treatment planning for an impacted canine tooth requires accurate information about its position. The aim of this study was to compare the diagnostic accuracy of two conventional orthodontic radiographic modalities with cone-beam computed tomography (CBCT) for localization of impacted maxillary canine teeth. Materials and Methods: Panoramic radiographs, lateral cephalograms, and CBCT scans of 30 patients with unilaterally impacted maxillary canine teeth were retrieved from the archives. Eight expert orthodontists evaluated the parameters related to the location of impacted canine teeth by using panoramic radiographs and lateral cephalograms of patients. After 4 weeks, the same parameters were evaluated on CBCT scans of patients. The diagnostic accuracy of conventional modalities and CBCT was compared with each other and also with the gold standard. Results: The conventional radiographic modalities and CBCT had similar accuracy for assessment of the overall inclination (p = 0.11), apex morphology (p = 0.18), and mesiodistal position of the apex (p = 0.12). CBCT had significantly higher accuracy for determination of incisal tip location (p = 0.001), labiopalatal (p = 0.001) and vertical (p = 0.01) position of the crown tip, minimum bone thickness covering the crown (p = 0.001), and root resorption of the adjacent tooth (p = 0.001). Conclusion: The combination of panoramic radiographs and lateral cephalograms was sufficiently accurate to assess some diagnostic parameters such as overall inclination, apex morphology, and mesiodistal apex location of impacted canine teeth.