Use of 3D Imaging for Treatment Planning in Cases of Impacted Canines

Background: The use of 3D imaging offers the possibility to improve diagnosis and treatment planning in several fields of dental science. Objective: The aim of this study is to evaluate the usefulness of 3D evaluation for surgical exposure treatment planning in cases of impacted canine. Methods: This retrospective study has been conducted on the clinical reports of twenty patients (11 F - 9 M) with a mean age of 15.4 years, affected by the impacted canine. Each patient underwent a CBCT exam (Hitachi MercuRay, Hitachi Medical Technology, Tokyo, Japan), in order to obtain sagittal, axial and coronal images and a 3D surface rendering. The images have been evaluated by 14 experts orthodontists who were divided into two groups. The first group first evaluates the bidimensional images and then the 3D images and the second group instead has done exactly the opposite. Each orthodontist has elaborated a treatment plan for the impacted canine correction with a specific indication about surgical exposure approach (Palatal-Vestibular) and orthodontic biomechanics. Results: The level of concordance in treatment planning of the 3D images evaluation and the bidimensional images was found to be greater in the second group of orthodontists. Moreover, in this group, the time spent for the treatment plan has been lower than in the first group (12 ± 3.32 min vs. 23 ± 2.53 min, p < 0.05). Conclusion: According to the results of the present study, it is possible to state that CBTC is fundamental for the diagnosis and treatment planning of impacted canine. However, further studies are necessary to confirm the greater reliability of 3D surface rendering compared to the bidimensional images.