Evaluation of Position and Treatment Difficulty of Impacted Maxillary Canine Using Cone Beam Computed Tomography: A Retrospective Study

Introduction: Impaction of the permanent maxillary canines is a serious dentaldevelopment disorder that affects about 3% of the general population. Its final positionin the occlusion is critical for the completion of the arch form, functional occlusion,dental symmetry, and harmony. Aim: The aim of the present study was to evaluatethe impacted maxillary canine location on 3D images and to determine positionalcomponents associated with impaction severity that may affect treatment difficulty.Material and methods: The current study included 40 CBCT scans of 40 unilateralimpacted canines where several angular and linear measurements on the reconstructedpanoramic, axial, sagittal, and coronal views were measured and then based on the anglebetween the impacted canine and their proposed post-treatment position, the samplewas divided to three impaction severity groups, group 1: Mild (IMPC/VAC <30º),group 2: Moderate (IMPC/VAC 30º-55º), and group 3: Severe (IMPC/VAC >55º).Results: Severity of impacted canines increased when their cusp tips were close tomidline distance<4mm ,and the vertical distance to the maxillary occlusal plan was>14mm, when their root apices were far from the dental midline a distance>23mm,and from the skeletal midline a distance>16mm. Severity of the impacted canine wasassociated with increased angulation IMPC/VAC>45º, IMPC/midline>45º, and IMPC/PL>120º. Conclusions: Cone beam computed tomography images enable thoroughlocalization of impacted canines and their relationship to neighboring anatomicalstructures, the use of virtual aligned canine in the recent study is a reliable and applicablemethod that can be used in future research.