IADR Abstract Archives

Cone-Beam-Computed-Tomography and Conventional-Radiographs in Maxillary-Impacted-Canine Localization and Root-Resorption Detection: Systematic-Review

Objectives: The aim is to systematically review the available literature on comparison between Cone-Beam Computed Tomography (CBCT) and conventional radiographs in localization of maxillary impacted canines, root resorption detection of lateral incisors and their effect on the treatment of choice.
Methods: Comprehensive electronic search through PubMed, CINHAL, Web of Science, and Chochrane Library databases and manual search up to 17 September 2014 was conducted by two reviewers. The review included any study design which compared CBCT with conventional radiographs to find any information deviation gained by the two modalities. Quality of studies that met selection criteria were assessed by Effective-Public Health-Practice-Project (EPHPP).
Results: Six studies evaluating various outcome variables for canine localization and meeting inclusion criteria were finally extracted. The outcomes are mainly categorized in: labiopalatal position, vertical position, mesiodistal position, angular measurements and the teeth relation to surrounding structures. Most assessed outcome variables are significantly different between the CBCT and conventional imaging. There is also statistically significant difference with large range of kappa agreement from 0.3 to 0.65 (fair to substantial agreement) in lateral incisors root resorption detection between these modalities. Three out of six included studies assessed therapeutic efficacy of CBCT and conventional radiographs. 70% to 73% agreement with broad range of kappa agreement 0.36 to 0.72 (fair to substantial agreement) between the imaging modalities was revealed. It is also reported statistically significant difference between the treatment of choice through them. However, the quality of studies was limited to be of “weak” or “moderate” quality. Meta-analysis was not appropriate due to the heterogeneous of results.
Conclusions: The information obtained from CBCT and conventional radiographs is deviant, and treatment of choice might be affected thorough CBCT imaging.
IADR/AADR/CADR General Session
2015 IADR/AADR/CADR General Session (Boston, Massachusetts)
Boston, Massachusetts
2015
0130
Diagnostic Sciences
  • Eslami, Ehsan  ( Loma Linda University , Loma Linda , California , United States )
  • Parhizkar, Yeganeh  ( Loma Linda University , Loma Linda , California , United States )
  • Kim, Jessica  ( Loma Linda University , Loma Linda , California , United States )
  • Barkhordar, Hamid  ( Harvard School of Dental Medicine , Boston , Massachusetts , United States )
  • None
    Oral Session
    Clinical Diagnostics
    Wednesday, 03/11/2015 , 01:30PM - 03:00PM
    Summary of results and quality assessment of studies assessing maxillary canine impaction.
    Authors Outcome Variables Results Study
    Quality
    Pittayapat
    2014

    -Canine localization (palatal, buccal, middle)
    -Canine angulation to midline
    - lateral root resoption
    CBCT vs OPG:
    -k = 0.2, 27.7% unidentified in OPG, p < .0001

    -k= 0.3, p < .0001
    -k= 0.3, p < .0001, unidentified 24% in OPG and 7% in CBCT.
    Moderate
    Lai
    2013

    -Labiopalatal canine localization
    -lateral root resoprtion
    CBCT vs OPG: (Pr agreement)
    -Pr: 0.29

    -Pr: 0.9
    Weak
    Wriedt
    2012
    Canine position
    -agreement in total between 2D and 3D


    -agreement in root resorption
    -agreement between two therapy proposals (alignment and surgical removal)
    Between OPG + study cast vs CBCT + study cast:
    -64%, k= 0.47

    *agreement with master findings: CBCT: 0.7, OPG: 0.37
    -agreement with master finding: CBCT: 0.6
    - k = .36. CBCT leads to the retraction of premature decisions to extract teeth.
    Moderate
    Alqerban
    2011
    angular distances :
    -Canine angle to lateral incisor
    -Canine angle to midline
    -Canine angle to occlusal plane
    -canine location: palatal, buccal, arch line)

    -root resorption detection
    2 CBCT vs OPT: (p-value)
    - NSD
    - NSD for A and <0.0001 for B group
    - 0.0101 for A and 0.0010 for B group
    -0.0074 for group A and P = 0.0008 for B


    - group A: 53% vs 29% , P = 0.0201
    group B: 50% vs 30%, P < 0.001
    Moderate

    Botticelli
    2011
    Canine localization:
    - Inclination to midline
    - Mesiodistal position of apex

    - Vertical level of crown
    - Overlap with lateral incisor
    - Labio-palatal crown position

    - Labio palatal apex position

    -Root resorption of neighbouring incisor
    - treatment choice
    CON (PA, LC, OPT) vs CBCT:
    - NSD , 74% agreement
    - 0.001 (p value): 64% agreement, less variation in apex position in 2D
    - 0.013: 66% agreement, higher vertical level in 2D
    - 0.001: 70% agreement, less overlap in 2D
    - 0.001: 68% agreement, more palatal position of crown in 2D, K= .3
    - 0.001: 65%, agreement, more palatal position of crown in 2D, K=.2
    - .0001, 82% agreement, K= .3, 2D indicated less root resorption
    - .0008, 70% agreement. CBCT leads more orthodontic and surgical intervention while 2D leads observational intervention.
    Moderate
    Haney
    2010
    impacted maxillary canines:
    -Mesiodistal cusp tip location
    - Labiopalatal location
    - Vertical location

    -root resorption detection
    -treatment plan
    Value of disagreement:
    - CBCT vs occlusal: 21% , K=.76
    - CBCT vs 2 periapical: 16% , K = 0.8, significant difference
    - CBCT vs panoramic: 50%, k = 0.63??
    -K= .65, P < 0.0001
    - < .0001. 73% agreement. k= .72
    Moderate