Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging

Objectives: The aim of this prospective study was to compare the impact of using twodimensional (2D) panoramic radiographs and three-dimensional (3D) cone beam CT for the surgical treatment planning of impacted maxillary canines. Methods: This study consisted of 32 subjects (19 females, 13 males) with a mean age of 25 years, referred for surgical intervention of 39 maxillary impacted canines. Initial 2D panoramic radiography was available, and 3D cone beam CT imaging was obtained upon clinical indication. Both 2D and 3D pre-operative radiographic diagnostic sets were subsequently analysed by six observers. Perioperative evaluations were conducted by the treating surgeon. McNemar tests, hierarchical logistic regression and linear mixed models were used to explore the differences in evaluations between imaging modalities. Results: Significantly higher confidence levels were observed for 3D image-based treatment plans than for 2D image-based plans (p<0.001). The evaluations of canine crown position, contact relationship and lateral incisor root resorption were significantly different between the 2D and 3D images. By contrast, pre- and perioperative evaluations were not significantly different between the two image modalities. Conclusions: Surgical treatment planning of impacted maxillary canines was not significantly different between panoramic and cone beam CT images.