2D Versus 3D Radiographs in the Localization of Upper Impacted Canines

Damascus University

Status: Completed

Conditions: Impacted Canines

Treatments: Other: Panoramic and lateral cephalometric radiography; Other: Surgery; Other: Cone beam computed tomography

Study type: Observational

Funder types: Other

Identifiers

NCT05745766

UDDS-Ortho-01-2023

Details and patient eligibility

About

Seventeen patients diagnosed with the extraction-based treatment of impacted maxillary canines will be included in this study. Each patient will undergo conventional 2D radiography including panoramic, and lateral cephalometric, in addition to 3D imaging by cone beam computed tomography (CBCT) images.

A set of variables will be evaluated on 2D and 3D images by a panel of assessors and then these results will be compared with the gold standard which will be established based on surgical detection and direct visualization of the impacted canine.

Full description

After taking the radiographic records, the impacted maxillary canines will be surgically exposed under local anesthesia where a full-thickness flap will be elevated from the buccal or palatal according to the initial radiographic diagnosis.

After cleaning the work yard to achieve good visibility, the pre-extraction parameters will be recorded which will be included labiopalatal position, mesiodistal position, and vertical position of the canine cusp, in addition to ankyloses of the impacted maxillary canine, proximity to the adjacent teeth, resorption of the adjacent incisors induced by the impacted maxillary canine, and bony coverage of the canine crown.

This will be followed by the extraction of the upper impacted canine and the recording of the post-extraction parameters, which will include the shape and the root apex development of the extracted canine. The pre- and post-extraction readings will be deemed the gold standard which will be compared to the 2D- and 3D-based assessments of the assessors.

Assessment sessions will be divided into two sessions with a one-week break in between. The first session will be devoted to the evaluation of the 2D image sets, while the second one will be to the evaluation of the 3D images.

Before beginning the assessment, the assessors will be subjected to a set of instructions and clarifications, including a set of graphs that help each assessor to accurately identify each variable, in addition to an oral explanation of some points so that the assessor will not fall into doubt when evaluating the radiographs.

Enrollment: 17 patients

Sex: All

Ages: 14 to 27 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients from both gender (Male and female), Age range: 14-27 years.
2. Unilateral impaction of the maxillary canines requiring surgical extraction.
3. Non-syndromic patients without any pathology of the maxillofacial region (benign or malignant tumor, cleft lip or cleft palate, trauma)
4. Patients with a set of panoramic and lateral cephalometric images, in addition to CBCT radiograph (CBCT is indicated for treatment planning)
5. The time period between taking the radiological records and undergoing the surgical intervention does not exceed four weeks

Exclusion criteria

1. Patients who had a systemic disorder, cleft lip/cleft palate, craniofacial syndrome, traumatic injury, and congenital number anomaly.
2. Patients had previous orthodontic treatment.

Trial design

17 participants in 3 patient groups

Canines assessed using 2D images

Description:

The 2D-based assessments of the impacted maxillary canine.

Treatment:

Other: Panoramic and lateral cephalometric radiography

Canines assessed using 3D images

Description:

The 3D-based assessments of the impacted maxillary canine.

Treatment:

Other: Cone beam computed tomography

Canines assessed intra-operatively or post-operatively

Description:

The gold standard-based assessments are based on surgical exposure.

Treatment:

Other: Surgery