Prevalence, Patterns, and Treatment Strategies for Impacted Canines: A 10‑Year Retrospective Study with a Retrospective Assessment of Hypothetical Cone Beam Computed Tomography Indications

Background: This study aimed to investigate the prevalence and patterns of impacted canines and to question the necessity of 3-dimensional imaging techniques in evaluation. Methods: A retrospective analysis of 175 impacted canines identified from panoramic radiographs and clinical records between 2013 and 2023 was conducted. All canine impactions were anatomically matched to the 7 categories listed in Yamamoto’s classification, and transmigrated teeth were also noted. Two oral surgeons independently evaluated the radiographs for impacted canine positions, associated pathosis, and treatment procedures. The need for cone beam computed tomography (CBCT) was also retrospectively assessed as a hypothetical clinical indication based on panoramic findings. Results: Most impacted canines were located in the maxilla (90.9%), and the majority of the sample consisted of canines in female patients (112 canines, 64.0%) compared with male patients (63 canines, 36.0%). Most cases were unilateral (73.7%). Type II impaction was the most common (54.9%) according to a standardized classification system. Transmigration occurred in 4 cases (2.3%), all in the mandible. Treatment varied by age (P < .001), with surgical exposure for orthodontic treatment more common in patients aged under 18 years, while extraction for prosthetic reasons or due to pathology/pain/infection was prevalent in older age groups. Cone beam computed tomography was retrospectively deemed indicated in 50.9% of cases, most commonly for evaluation of the labio-palatal position of the impacted canines. Conclusion: This study emphasizes the importance of timely diagnosis and management of impacted canines. Panoramic radiographs remain useful for initial assessment, whereas CBCT should be used selectively when 2-dimensional (2D) imaging is inconclusive or when pathology is suspected. Yamamoto’s classification should therefore be interpreted as a descriptive aid rather than evidence of the superiority of 2D imaging.