Methodological Design for Three-Dimensional Assessment of Maxillary and Mandibular Impacted Canines by Cone-Beam Computed Tomography: A Scoping Review.

To map and critically synthesize the methodological approaches used for the CBCT-based evaluation of maxillary and mandibular impacted canines (ICs), with emphasis on imaging protocols, anatomical variables, and diagnostic frameworks. This scoping review followed PRISMA-ScR guidelines. A three-step search strategy was applied across PubMed, Embase, Web of Science, Scopus, LIVIVO, Cochrane Library, LILACS, and Google Scholar, using MeSH terms and free-text keywords related to ICs and CBCT. Data on sample characteristics, CBCT acquisition parameters, anatomical assessment criteria, classification systems, segmentation software, and examiner calibration were extracted and synthesized narratively. Forty-nine observational studies met the inclusion criteria. Substantial heterogeneity was observed in CBCT equipment, voxel size, field of view, exposure settings, image orientation, segmentation tools, and calibration procedures. Most studies evaluated maxillary canines, whereas mandibular impactions were rarely assessed (6.12%). The most frequently analysed characteristics were the impacted canine's position within the alveolar bone, its involvement in adjacent tooth resorption, and its spatial relationship to surrounding teeth. Major methodological gaps were identified in CBCT acquisition protocols, image orientation, examiner reliability, classification systems, and the assessment of follicular and impacted canine morphology, volume, shape, and anatomical relationships to adjacent structures widely used classification systems, particularly Ericson-Kurol, showed variable adaptations and limited standardization. Most studies evaluated maxillary canines, focusing on bucco-palatal position, root resorption, and the Ericson and Kurol classification, although CBCT methodologies were inconsistently reported. Standardized acquisition, orientation, and measurement protocols may improve diagnostic consistency and support more reliable orthodontic treatment planning and clinical decision-making for impacted canines.