Frequency of odontogenic lesions in patients with impacted maxillary canines and the association with impaction characteristics

Background. Since impacted canines are a frequent eruptive anomaly, it is imperative to study their etiological aspects. A possible cause of impaction is the presence of odontogenic lesions close to the impacted canine. Objectives. The aim of this study was to evaluate the frequency of odontogenic lesions in patients with impacted canines and their association with the characteristics of impaction. Material and methods. This cross-sectional study was carried out with the scans of 93 impacted maxillary canines obtained from cone-beam computed tomography (CBCT) studies performed in 3 radiological centers. The selection criteria regarded male and female patients older than 12 years, and were based on the CBCT scans of impacted canines, showing unilateral or bilateral maxillary impaction, with or without odontogenic lesions. The position of the impacted canines, the sector of impaction, the presence or absence of a dentigerous cyst, an odontoma or follicular enlargement, as well as the total diameter of the lesion, were evaluated. The χ² test and logistic regression analysis were performed, and the level of statistical significance was set at p < 0.05. Results. The frequency of odontogenic lesions near the canine impaction area was generally low (7.5% for a dentigerous cyst, 6.5% for follicular enlargement and 3.2% for a mesiodens). However, there was a significant association between the presence of a dentigerous cyst and buccal or mid-alveolar impacted canines (p = 0.032). The alpha and beta angles influenced the possibility of the occurrence of dentigerous cysts, with the alpha angle increasing the risk (B = 1.22; p = 0.041) and the beta angle decreasing the chance of developing a dentigerous cyst (18%) (p = 0.024). Conclusions. The presence of odontogenic lesions in impacted maxillary canine cases is low, and involves mainly dentigerous cysts and follicular enlargement in buccal or mid-alveolar impacted canines. The alpha and beta angles may influence the development of dentigerous cysts.