Cureus · 2025
Comparison of Panoramic Radiography and Cone Beam Computed Tomography in Assessing the Position of Impacted Maxillary Canines.
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Karabiyik Ahmet E, Sumer Ayse P
Аннотация
INTRODUCTION: This study aimed to assess the clinical applicability of a panoramic radiograph (PR)-based threshold angle for distinguishing the buccopalatal position of impacted maxillary canines, using cone-beam computed tomography (CBCT) as a reference for verification.
METHODS: A total of 152 impacted maxillary canines from 129 patients were evaluated. The angle of each impacted canine was measured on PR between the long axis of the tooth and the intermolar line. CBCT was used as a reference standard to confirm the buccopalatal position of each canine. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal PR-based angle threshold value for distinguishing buccal and palatal impactions.
RESULTS: The intraobserver reliability for PR angle measurements was excellent (intraclass correlation coefficient (ICC) = 0.957). An optimal PR angle threshold value of 50.4° was identified for differentiating buccal from palatal impactions. However, this value did not achieve statistical significance in the overall cohort (p = 0.106; sensitivity = 52.6%, specificity = 70.2%). In the subgroup of unilaterally impacted canines, the same threshold value reached statistical significance (p < 0.05) with a sensitivity of 62% and a specificity of 75%. Despite these findings, the predictive accuracy of PR remained insufficient for reliable clinical application.
CONCLUSION: The study demonstrated that a PR-based angle threshold value of 50.4° can provide a preliminary estimation of the buccopalatal position of impacted maxillary canines, but its diagnostic accuracy is limited. CBCT remains the preferred method for definitive localization.
METHODS: A total of 152 impacted maxillary canines from 129 patients were evaluated. The angle of each impacted canine was measured on PR between the long axis of the tooth and the intermolar line. CBCT was used as a reference standard to confirm the buccopalatal position of each canine. Receiver-operating characteristic (ROC) analysis was performed to determine the optimal PR-based angle threshold value for distinguishing buccal and palatal impactions.
RESULTS: The intraobserver reliability for PR angle measurements was excellent (intraclass correlation coefficient (ICC) = 0.957). An optimal PR angle threshold value of 50.4° was identified for differentiating buccal from palatal impactions. However, this value did not achieve statistical significance in the overall cohort (p = 0.106; sensitivity = 52.6%, specificity = 70.2%). In the subgroup of unilaterally impacted canines, the same threshold value reached statistical significance (p < 0.05) with a sensitivity of 62% and a specificity of 75%. Despite these findings, the predictive accuracy of PR remained insufficient for reliable clinical application.
CONCLUSION: The study demonstrated that a PR-based angle threshold value of 50.4° can provide a preliminary estimation of the buccopalatal position of impacted maxillary canines, but its diagnostic accuracy is limited. CBCT remains the preferred method for definitive localization.