Predictive Value of Impacted Maxillary Canine Using Panoramic Radiography and Cone Beam Computed Tomography - A Retrospective Study

Abstract

Impacted maxillary canines (IMCs) are common eruption disturbances associated with incisor root resorption. Panoramic radiography (PR) is routinely used for initial assessment, but its reliability in localising IMCs is limited. Cone beam computed tomography (CBCT) provides accurate three-dimensional localisation. This study aimed to assess the reliability of panoramic sector localisation in evaluating IMCs and associated root resorption using CBCT. This retrospective study evaluated imaging records of 92 patients aged ≥13 years with unilateral IMCs. Sector localisation was performed on PR using Lindauer et al .’s criteria, and CBCT was used to assess position and adjacent incisor root resorption. Data were analysed using descriptive statistics, Chi-square test and Cohen’s kappa test ( P < 0.05). Sector III was the most common location (40.2%). A significant association was found between sector localisation on PR and CBCT position ( P < 0.001), with palatal impactions mainly in Sectors III and IV. Root resorption was more frequent in lateral incisors, particularly in Sectors II and III. Inter- and intra-observer reliability analyses demonstrated substantial agreement, with a Cohen’s kappa value of κ =0.78 ( P < 0.001). Panoramic sector analysis showed good reliability with CBCT in predicting canine position. While PR remains a useful screening tool, CBCT offers superior diagnostic accuracy for three-dimensional localisation and detection of early root resorption, thereby aiding in optimal treatment planning.