The Effect of the Dental Follicle Volume of Palatally Impacted Maxillary Canines on the Relative Position of the Adjacent Teeth
Creators: Lam, Michael D.
Publisher: name: University of Alberta Library
Year: 2023

<p>Introduction: Cone-Beam Computed Tomography (CBCT) has provided in-depth three-dimensional insight into the field of dentistry that were not readily available in the past.  It is typically used as an adjunct with traditional imaging modalities to use as a diagnostic aid in orthodontics where uncertainty exists such as planning and treating impacted dentition.  The primary objective of this study is to assess how the volume of the dental follicle of palatally impacted maxillary canines affects the relative position (in terms of tip, torque, and rotation) of the adjacent lateral incisor and first premolar using CBCT imaging.  </p>

<p>Methods:  The sample consists of 49 patients with unilaterally palatally impacted maxillary canines with dental follicles who had CBCT imaging taken.  These 49 patients were further assigned to a lateral incisor sample (n = 49) and first premolar sample (n = 23) dependent on the direct contact of the dental follicle to that adjacent tooth.  Using CBCT imaging software (OsiriX DICOM Viewer), a manual human segmentation technique was used to obtain the volumetric measurements of the dental follicle of the impacted maxillary canine and angular measurements of the adjacent lateral incisor and first premolar were obtained by using the palatal plane (ANS – PNS) as a reference plane.  The angles were then compared to the contralateral non-impacted side which acted as the control.  Intraclass coefficient was used to measure the reliability of the principal investigator’s angular and volumetric measurements as well as the reliability of the volumetric measurements amongst the three participating investigators.  A multivariant regression analysis was used. Data analysis was performed using IBM SPSS Software and statistical significance was set at α=0.05.</p>

<p>Results:  Intra-rater reliability for the first premolar tip and torque angular measurements were good, as the Intra-Class Correlation (ICC) was measured at 0.896 (0.796, 0.954) and 0.861 (0.734, 0.937), respectively. Intra-rater reliability was excellent for the dental follicle volume, lateral incisor tip, torque and rotation, and first premolar rotation, as the ICC was measured at 0.979 [0.940,0.994], 0.921 [0.844, 0.965], 0.971 [0.941, 0.988], 0.995 [0.989, 0.998], and 0.936 [0.871, 0.972] respectively.  Inter-rater reliability was good for the dental follicle volume amongst the three investigators, as the ICC was measured at 0.876 [0.707, 0.973].  The multivariant regression analysis implied that there is no difference in the mean change in the tip, torque, and rotation of the lateral incisor and first premolar between the impacted and control sides when dental follicle volumes are considered (p = 0.509 for the lateral incisor sample and p = 0.804 for the first premolar sample).    </p>

<p>Conclusion:  The dental follicle volume of the palatally impacted maxillary canine does not seem to influence the relative position of the adjacent lateral incisor and first premolar. There was no statistically significant difference between the change in angular tip, torque, and rotation of the adjacent teeth between the impacted and control maxillary canine sides.</p>