TY - JOUR
T1 - Three-dimensional decision support system for treatment of canine impaction
AU - Keener, Dylan J.
AU - de Oliveira Ruellas, Antonio Carlos
AU - Aliaga-Del Castillo, Aron
AU - Arriola-Guillén, Luis Ernesto
AU - Bianchi, Jonas
AU - Oh, Heesoo
AU - Gurgel, Marcela Lima
AU - Benavides, Erika
AU - Soki, Fabiana
AU - Rodríguez-Cárdenas, Yalil Augusto
AU - Ruíz-Mora, Gustavo Armando
AU - Barkley, Mary
AU - Gebeck, Thomas
AU - Hannapel, Eric
AU - McClatchey, Laurie Mc Namara
AU - Pinzon, Maria
AU - Roberts, Christopher
AU - Cevidanes, Lucia
N1 - Publisher Copyright:
© 2023 American Association of Orthodontists
PY - 2023/10
Y1 - 2023/10
N2 - Introduction: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. Methods: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. Results: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. Conclusions: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.
AB - Introduction: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. Methods: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. Results: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. Conclusions: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.
UR - http://www.scopus.com/inward/record.url?scp=85152656120&partnerID=8YFLogxK
U2 - 10.1016/j.ajodo.2023.02.016
DO - 10.1016/j.ajodo.2023.02.016
M3 - Artículo
AN - SCOPUS:85152656120
SN - 0889-5406
VL - 164
SP - 491
EP - 504
JO - American Journal of Orthodontics and Dentofacial Orthopedics
JF - American Journal of Orthodontics and Dentofacial Orthopedics
IS - 4
ER -