2D Versus 3D Radiographs in the Localization of Upper Impacted Canines
Condition: Impacted Canines
MeSH terms: Tooth, Impacted
Study type: Observational

Summary: 
      Seventeen patients diagnosed with the extraction-based treatment of impacted maxillary
      canines will be included in this study. Each patient will undergo conventional 2D radiography
      including panoramic, and lateral cephalometric, in addition to 3D imaging by cone beam
      computed tomography (CBCT) images.

      A set of variables will be evaluated on 2D and 3D images by a panel of assessors and then
      these results will be compared with the gold standard which will be established based on
      surgical detection and direct visualization of the impacted canine.
    

Detailed description: 
      After taking the radiographic records, the impacted maxillary canines will be surgically
      exposed under local anesthesia where a full-thickness flap will be elevated from the buccal
      or palatal according to the initial radiographic diagnosis.

      After cleaning the work yard to achieve good visibility, the pre-extraction parameters will
      be recorded which will be included labiopalatal position, mesiodistal position, and vertical
      position of the canine cusp, in addition to ankyloses of the impacted maxillary canine,
      proximity to the adjacent teeth, resorption of the adjacent incisors induced by the impacted
      maxillary canine, and bony coverage of the canine crown.

      This will be followed by the extraction of the upper impacted canine and the recording of the
      post-extraction parameters, which will include the shape and the root apex development of the
      extracted canine. The pre- and post-extraction readings will be deemed the gold standard
      which will be compared to the 2D- and 3D-based assessments of the assessors.

      Assessment sessions will be divided into two sessions with a one-week break in between. The
      first session will be devoted to the evaluation of the 2D image sets, while the second one
      will be to the evaluation of the 3D images.

      Before beginning the assessment, the assessors will be subjected to a set of instructions and
      clarifications, including a set of graphs that help each assessor to accurately identify each
      variable, in addition to an oral explanation of some points so that the assessor will not
      fall into doubt when evaluating the radiographs.
    

Intervention name(s): Panoramic and lateral cephalometric radiography; Cone beam computed tomography; Surgery
Intervention type(s): Other; Other; Other
Intervention description(s): The 2D-based assessments of the impacted maxillary canine will be achieved using panoramic and lateral cephalometric radiographs.; The 3D-based assessments of the impacted maxillary canine will be achieved using a cone beam computed tomography (CBCT) image.; The surgical exposure will be accomplished, and the impacted maxillary canine will be assessed by a direct vision.
Observational model: Case-Only
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Patients with impacted canines. These canines should be located unilaterally. The
        orthodontic decision should include the removal of these impacted canines in the course of
        orthodontic treatment.