The Reliability of Panoramic Radiographs in the Evaluation of Location for Impacted Maxillary Canine Teeth: Comparison of Prediction Methods

Abstract

Introduction: The sagittal locations of Impacted Maxillary Canine (IMC) can be predicted on panoramic radiographs (OPGs). In general, the prediction methods that include the superimposition of the IMC crown on the root or neck of the adjacent incisor, determination of the sector of IMC crown, magnification of IMC, vertical level of IMC crown and angulation of IMC can be used for localising the maxillary IMC, as labially or palatally. The reliability of these prediction methods should be discussed. Aim: To compare the reliability of prediction methods used for detecting the sagittal location of IMC with only a single OPG, according to method’s success, need for Cone-Beam Computerised Tomography (CBCT) and contentment with method. The effects of the vertical level, included sector and angulation of IMCs were examined regarding the method’s success. Materials and Methods: OPG-CBCT records of 69 individuals with IMCs (53-unilateral, 16-bilateral; 85-in total) were included in the study. An experimental research design was performed to measure the validity and reliability of prediction methods. Sagittal locations were predicted using superimposition, sectors, magnification, angulation and combined methods by 25 volunteer dentists. The prediction results of volunteers were compared with true locations determined by CBCT. Need for CBCT, volunteer contentment with method was evaluated statistically. The similarities between each frequency distribution of IMC for methods and the true position were examined by Kappa test. The Mann-Whitney U test for two independent groups, Kruskal-Wallis test for more than two independent groups and Friedman test for more than two dependent groups were used. The Bonferroni–Dunn and the CF multiple comparison tests were used for the multiple comparison methods. Results: Prediction methods showed statistically similar mean ranks. The highest need for CBCT was for the magnification and combined methods. The highest contentment with method was obtained with the superimposition and the lowest with the magnification method. The highest prediction success for location was obtained for IMCs that were localised in Sector 1 (canine cusp tip corresponds to the deciduous canine) and Sector 5 (canine cusp tip corresponds to the midline of the central incisor) in all methods. Conclusion: For the accurate prediction of the true IMC location, the success of the prediction methods for OPG was similar. Sectors 1 and 5 were the locations where sagittal position of IMC was predicted with high accuracy.

Keywords

• cone-beam computed tomography
• cuspid
• digital radiography
• tooth eruption
• unerupted tooth