J Huazhong Univ Sci Technol [Med Sci]

34(3):425-430,2014
DOI 10.1007/s11596-014-1295-z 425
J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014

Three-dimensional Localization of Impacted Canines and Root

Resorption Assessment Using Cone Beam Computed Tomography*
Eyad Almuhtaseb1, Jing MAO (毛 靖)1#, Derek Mahony2, Rawan Bader3, Zhi-xing ZHANG (张智星)1
1
Department of Orthodontics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
430022, China
2
Department of Orthodontics, London Dental School, London, United Kingdom
3
Ministry of Health, Kingdom of Saudi Arabia

© Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2014

Summary: The purpose of this study was to develop a new way to localize the impacted canines from
three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam com-
puted tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted
canines in Tongji Hospital were examined. The images of CBCT scans were obtained from KaVo 3D
exam vision. Angular and linear measurements of the cusp tip and root apex according to the three
planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo
Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the max-
illary and mandibular canines were obtained. Using this technique the operators could envision the loca-
tion of the impacted canine according to the three clinical planes. Adjacent teeth root resorption of 28.26
% was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption
was found in our samples. Accurate and reliable localization of the impacted canines could be obtained
from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients
with impacted canines.
Key words: impacted canines; root resorption; cone beam computed tomography


Permanent canines have an important esthetic and
functional role in the oral cavity. Impacted tooth can be
defined as the tooth that has failed to erupt into its proper
position in the dental arch within its normal period of
growth, and it has no further indication that it will erupt
completely based on clinical and radiographic assess-
ment[1, 2]. Canines that are impacted are relatively com-
mon in orthodontic practice. Impacted maxillary canine
(IMC) is the second most frequently impacted teeth after
the third molar in 1%–3% of general population[1–5]. The
incidence of IMC is more than ten to twenty times that in
the mandible[6, 7]. The etiology of impacted canine is
multifactorial, which includes genetics and local factors
that play important roles. The incidence shows predomi-
nance in females to males of 3:3.2[8, 9]. According to the
study by Peck et al[8], palatal canine impaction is genetic
in origin, whereas facial impaction is caused by inade-
quate arch length or crowding.
The prevalence of IMC has a variable distribution
with regards to ethnic groups[1–6]. Key data were origi-
nally illustrated by Montelius et al, showing a difference
between Caucasians and oriental populations. He re-
ported that the frequency of 1.7% for the Chinese popu-
lation is relatively low compared to the frequency of
5.9% for the Caucasians[10]. In general, maxillary canine
impaction is more often located palatally (85%) than
Eyad Almuhtaseb, E-mail: dreyad1511@gmail.com
#
Corresponding author, E-mail: maojing@mail.hust.edu.cn
labially (15%)[6, 7]. Peck et al reported that impacted ca-
nines in Asians are usually mid-alveolus or labial. They
calculated the prevalence ratio of European:Asian was
2:1 for all types of maxillary impacted canines, and that
of European:Asian was 5:1 for palatal position[8]. Among
all patients with IMCs, 8% have bilateral impactions[11].
Small, peg-shaped or missing maxillary lateral incisors
have been associated with palatally impacted canines[11].
Mismanagement, failure to diagnose or untreated
impacted canines can lead to external resorption of adja-
cent teeth, especially the lateral incisors, aesthetic prob-
lems, malalignment of neighboring teeth, shortened den-
tal arches, and an increase in the occurrence of follicular
cyst formation and recurrent infections, resulting in irre-
versible damage that may potentially eventually cause
tooth loss[11–14].
Various studies showed an increase in adjacent teeth
root resorption with one study showing an increase in
incidence of as much as 48%[12].
To obtain accurate orthodontic-surgical manage-
ment we need accurate localization of the impacted ca-
nines. Traditionally, diagnosis of impacted canines is
made by conventional two-dimensional methods (e.g.
cephalometric, panoramic, periapical, occlusal) and it
was difficult to localize and determine the root resorption
because of the superimposition of structures in the film,
which leads to difficulty in distinguishing many signifi-
cant details. In most cases, more than one radiograph is
necessary[6]. The longitudinal axes of the impacted ca-
nines are often inaccurate, whereas magnification, arti-
 426
facts and distortion often occur as well. Therefore the
skill of the operator is imperative. Studies showed that
even with a highly trained operator, many misdiagnoses
and mismanagement still occur[11–15].
To counter these problems, many operators have
started using the spiral computed tomography (CT) scan.
This method allows excellent tissue contrast and precise
three-dimensional images, but two main problems still
remain, the relatively high dose of radiation and its high
cost[2, 6, 16, 17]. The spiral CT is the bridge between con-
ventional radiographs and the newly invented cone-beam
computed tomography (CBCT), a method used for the
localization, diagnosis and formation of treatment plans
for impacted canines. It provides precise localization and
a significantly lower dose of radiation as compared to the
traditional CT[1, 5, 18–20].
The aim of this study was to use CT to localize the
impacted canines, to analyze the root resorption caused
by the impacted canines in our study sample, as well as
to find methodological connection between the CBCT
and clinical interventions.
1 MATERIALS AND METHODS
CBCT scans of 46 (17 males, and 29 females) pa-
tients with impacted canines undergoing orthodontic
treatment at the Orthodontic Department, Tongji Hospital,
Tongji Medical College, Huazhong University of Science
and Technology (China), were included in this study
(required approvals were obtained).
These patients were referred for localization of
these impacted teeth between January 2013 and October
2013, using CBCT (KaVo 3D eXam vision) KaVo (Ger-
many). The CBCT images were collected from the work
Fig. 1 A: Localization of the sella turcica; B and C: localication of apex, incisor edge and labial point of incisors to define upper and
lower incisor profile; D and E: localization of apex, anterior and posterior cusp point of the 1st molar to define upper and lower
1st molar. Occlusal plane can be accurately defined by bisecting the posterior teeth toward the upper incisor edge; F: localiza-
tion of canine by defining apex and cusp tip
The following land marks were defined to obtain
the three planes: Sella (midpoint of the sella turcica),
nasion (most anterior point of the fronto-nasal suture),
right and left portion (upper-most point on bony external
auditory meatus), upper and lower incisor profile, upper
and lower first molar profile, maxillary profile, symphy-
J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014
station of the radiology department of the dental center.
Eight patients had upper bilateral impacted canines, 35
had upper unilateral impacted canines, and 5 lower im-
pacted canines were found. Age range was from 11 to 41
years old with a mean age of 16.5±6.2.
The patients were scanned using the kavo 3D CBCT
machine (KaVo 3D eXam vision, Germany) in an upright
position using a 12-inch-diameter field of view (FOV)
with parameters of 120-KVp 5Ma, 0.25-mm slice thick-
ness and a total of 528 slices in the digital imaging in
communications in medicine (DICOM) format as part of
the diagnostic evaluation for their orthodontic treatment.
The cone beam-generated DICOM files were im-
ported into Invivo 5 anatomage imaging (Germany) 5.1
software and reoriented to set the X, Y, and Z planes
using internal land marks and cranial base structures in
the sagittal view. The X-axis view was set along the
sella-nasion line (a line from the frontonasal suture to the
center of the sellaturcica). The line tangent to the clivus
in the base of the skull was set as the Y-axis in the cor-
onal view. The Z-axis was defined by the line bisecting
the optic foramina. The reorientation was done only
once.
The InVivo Dental Anatomage Version 5.1.10 has
the advantage of checking the correct position of the pa-
tient before exposure and adjustments are made if re-
quired.
The three-dimensional tool in the software was used
for analysis. This tool was beneficial in determining the
required points to define the occlusal, frontal and mid-
sagittal planes in a more precise way and it further auto-
matically defined and generated these three planes using
the cephalometric feature in it (fig. 1 and 2).
sis profile, ANS anterior and PNS posterior nasal spine,
point A (deepest concavity on the anterior profile of the
maxilla) and point B (deepest concavity on the anterior
profile of the mandibular symphysis pogonion. We then
defined the cusp tip and apex tip of the impacted canines
to get the longitudinal axis of the impacted canine, which
J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014
is automatically generated by the software. With the aid
of the three-dimensional tool setting the software was
used to make the angular and linear measurements of the
Fig. 2 A and B: the three planes (midsagittal, occlusal and frontal) with the coordinate measurements of the canine; C and D: differ-
ent simulation we needed to locate the cusp tip and apex accurately
The midsagittal plane passes through the facial mid-
line and divides the face into right and left halves defined
from the nasion and menton. The occlusal plane is de-
fined as the line bisecting the posterior occlusion of the
permanent molars and premolars (or deciduous molars in
mixed dentition) and extends anteriorly to touch the up-
per incisor edge. The frontal plane was defined from the
anterior point of the frontonasal suture (nasion) to point
A for the upper impacted canine cases and to point B for
the lower impacted canine cases respectively.
After that we used the software to obtain the linear
and angular measurements according to these three
planes, valuable to both the oral surgeon and the ortho-
dontist to localize the impacted canine in a clear way to
obtain better diagnosis and management plans.
The resorption of the adjacent teeth was analyzed
according to the grading system suggested by Ericson
and Kurol[7]: No resorption, intact root surfaces; Mild
resorption, resorption midway to the pulp or more, the
pulp lining being unbroken; moderate resorption, the
pulp is exposed by the resorption, and the involved
length of the root is shorter than one third of the entire
root; severe resorption, the pulp is exposed by the re-
sorption, and the involved length is longer than one third
of the root.
For the assessment and the localization of the re-
quired points and landmarks we viewed all simulation
features in axial trans-axial and coronal views, and the
427
cusp tip and root apex to the three planes (mid sagittal,
occlusal and frontal).
clipping feature was used in all dimensions to be precise
in localizing the points.
To check the reliability and the accuracy in localiz-
ing the point using the software, we compared measure-
ments obtained by the first author to those obtained by
the CBCT technician in the radiology department for the
imaging of 10 patients. It was found the results were very
similar and CBCT was precise with a mere difference of
just 0.02 mm, 1 degree difference in some linear and
angular measurements.
There was no significant difference between the two
operator’s measurements, confirming the reliability and
the ease of obtaining accurate measurements.
Statistical analyses were conducted using the SPSS
software (version 11.0, SPSS Inc., USA). The student
T-test was carried out to compare the differences be-
tween males and females. The chi-square test was con-
ducted to compare the association between gender and
root resorption, crowding, anomalies and deciduous teeth.
The spearman correlation test was used to examine the
relationship between root resorption, crowding, anoma-
lies and deciduous teeth. For all comparisons, a P value
of less than 0.05 by a two-sided test was considered sta-
tistically significant.
2 RESULTS
Of a total of 46 patients in our study, 63% (n=29)
 428 J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014

were females and 37% (n=17) were males. The age in
general range was between 10 and 41 years and the mean
age was 16.5±6.2. The lower impacted canine cases were
presented in 5 patients, all of which were right unilateral
cases, including 3 males and 2 females. The number of
upper impacted canines cases were 43 in total: n=8 for
bilateral, n=13 for upper left, and n=22 for upper right.
Male impactions presented with 6 cases of upper
left, 6 cases of upper right, 4 cases of upper bimaxillary,
and 3 cases of lower right. Female impactions presented
with 7 cases of upper left, 16 cases of upper right, 4
cases of bimaxillary, and 2 cases of lower right. There
were 4 males and 4 females with bilateral impacted ca-
nines (two of the upper male bilateral impacted canines
combined with lower impacted canines)
Retained deciduous canines were analyzed. Of the
46 cases of the impacted canines, there were 36 cases of
the deciduous canines (78.3%).
Crowding was measured. In total, 38 (82.6%) pa-
tients were sampled. In terms of gender, 88.25% of the
males had crowding, as compared with a slightly less
79.3% in the females. In our study 13 cases had mild
crowding, 15 had moderate crowding, 10 cases had se-
vere crowding, and no crowding was seen in 8 patients.
Most of the upper impacted canines were located
facially in 40.2% of the patients, 37.6% were located
palatally, while 22.2% were located in midalveolus.
The lower impacted canines were located buccally
(60%) and in midalveolus (40%).
Anomalies associated with impacted canines were
investigated. We found small or peg laterals in 12 cases,
missing laterals in 2 cases, impacted lateral incisors in 2
cases, and an impacted central and lateral incisor in one
case. Eight cases had supernumerary teeth, and 2 cases
had odontomes. Three cases had transposition with lat-
eral incisors, and 2 cases had transposition with the 1st
premolar (table 1).

Table 1 Associated anomalies in the impacted canine cases

Associated anomalies n
Small or peg laterals 12
Missing laterals 2
Impacted central and lateral incisors 1
Odontomes 2
Transposition with lateral incisors 3
Transposition with first premolar 1
Retained deciduous canine 10

Canines in touch with other teeth were analyzed. tion. Most of the root resorption was in the lateral inci-
59% of canines got touch with other teeth. Fourteen sors (n=11, 23.9%), while 8.69% (n=4) of root resorption
cases of canines got touch with lateral incisors, 8 cases in central incisors.
with the central incisors and 5 cases with premolars (4 In lower impacted canine cases, no root resorption
with 1st premolar, and 1 with 2nd premolar). was found.
In upper impacted canine cases root resorption was The coordinates in the upper impacted canines are
measured. It was found 32.6% (n=15) of patients had shown in tables 2, 3 and 4.
root resorption. Of these, we further found 17.39% (n=8) The linear measurements of the impacted canines
had mild root resorption, 10.87% (n=5) had moderate cusp tip to the midsagittal plane, the occlusal plane and
root resorption, and 4.35% (n=2) had severe root resorp- frontal plane were –2.2–30.5 mm, 2.3–28.6 mm and
tion. 67.39% (n=31) of the patients had no root resorp- 0.3–20.6 mm respectively.
Table 2 Coordinate measurements from cusp tip and root apex to the midsagittal plane in upper impacted canine cases
Angular to midsagittal Root apex to midsagittal Cusp tip to midsagittal n Gender
±s Range ±s Range ±s Range
19.9±14.4˚ 1.2–43.9˚ 14.6±9.7 –16–23.7 14.9±9.66 –2.2–30.5 14 Male
28.1±18.1˚ 1.7–66.6˚ 14.7±8.24 –17–32.4 8.68±7.90 –1.2–29.7 27 Female
Table 3 Coordinates measurements from cusp tip and root apex to occlusal plane in upper impacted canine cases
Angular to occlusal plane Root apex to occlusal plane Cusp tip to occlusal plane n Gender
±s Range ±s Range ±s Range
50.0±16.7˚ 8.9–71.3˚ 24.7±5.33 10.8–31.5 9.96±3.37 5.2–19.5 14 Male
72.9±134˚ 17.8–741˚ 22.9±3.93 11.7–27.9 10.4±5.60 2.3–28.6 27 Female
Table 4 Coordinates measurements from cusp tip and root apex to frontal plane in upper impacted canine cases
Angular to frontal plane Root apex to frontal plane Cusp tip to frontal plane n Gender
±s Range ±s Range ±s Range
19.5±16.2˚ 4.3–66.5˚ 17.4±20. 0.6–85.5 8.23±4.60 1.8–20.6 14 Male
19.6±12.0˚ 1.4–59.3˚ 12.3±5.70 4.6–28.8 5.27±3.16 0.3–14.5 27 Female
Table 5 Coordinate measurements from cusp tip and root apex to midsagittal plane in lower impacted canine cases
Angular to midsagittal Root apex to midsagittal Cusp tip to midsagittal n Gender
±s Range ±s Range ±s Range
43.4±27.1˚ 25.2–74.6˚ 9.4±5.67 3.4–14.7 12.6±8.4 2.8–17.7 3 Male
22.8±11.5˚ 14.7–31.0˚ 6.3±4.16 3.3–9.2 7.8±0.27 7.6–8.0 2 Female
J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014
Table 6 Coordinate measurements from cusp tip and root apex to the occlusal plane in lower impacted canine cases
Angular to occlusal plane Root apex to occlusal plane
±s Range ±s Range
37.5±29.6˚ 3.4–55.5˚ 26.9±1.28 25.6–28.2
74.8±7.94˚ 69.2–80.5˚ -1.8±41.2 -31–27.4
Table 7 Coordinate measurements from cusp tip and root apex to the frontal plane in lower impacted canine cases
Angular to frontal plane Root apex to frontal plane
±s Range ±s Range
14.6±7.54˚ 6.6–21.5˚ 4.64±2.79 1.6–7.1
12.7±12.9˚ 3.5–21.8˚ 11.6±8.62 5.5–17.7
The linear measurements from the root apex to the
midsagittal plane, the occlusal plane and the frontal plane
were 17–32.4, 10.8–31.5 and 0.6–85.5 mm respectively.
The angular measurements of root apex-cusp tip to
th midsagittal plane, the occlusal plane and the frontal
plane were 1.2–66.6˚, 8.9–74.1˚ and 1.4–66.5˚ respec-
tively.
In the lower impacted canines (tables 5, 6, and 7),
the linear measurements of the cusp tip to the midsagittal
plane, the occlusal plane and the frontal plane were
2.8–17.7 mm, 12–21.1 mm and 0.8–11.3 mm respec-
tively.
The linear measurements of the root apex to the
midsagittal plane, the occlusal plane and the frontal plane
were 3.3–14.7 mm, 31–28.2 mm and 1.6–17.7 mm re-
spectively.
The angular measurements of the root apex-cusp tip
to the midsagittal plane, the occlusal plane and the fron-
tal plane were 14.7–74.6˚, 3.4–80.5˚ and 3.5–21.8˚, re-
spectively.
3 DISCUSSION
In this study the impacted canines were localized in
three-dimensional planes. We made the cusp tip and root
apex linear and angular measurements in the three clini-
cal planes (midsagittal, occlusal and frontal) to provide
the clinician with measurements that can help him/her to
envision the location of the impacted canines.
Berco reported that CBCT showed accurate and re-
liable three-dimensional measurement of the craniofacial
complex. These accuracy and reliability was not affected
by the skull orientation during CBCT scan[20].
Olszewski et el concluded in his study that the cra-
niofacial cephalometric identification of the land marks
was accurate and maintained even with low-dose of ra-
diation, as low as 35 mAs, and he recommended to use
low dose of radiation for clinical three-dimensional
cephalometric application[21].
The study on the panoramic radiograph which is
commonly used in orthodontic treatment revealed that
it’s not a reliable method to localize impacted canines[22].
Botticelli et al compared the management of pa-
tients when the clinicians used two-dimensional and
three-dimensional image sets, and found the treatment
plans were different. They found that three-dimensional
examinations more often lead to an approach of expan-
sion and orthodontic traction. Also higher degree of dif-
ficulty of the case was judged on the basis of the
three-dimensional image set. They concluded that more
precise and accurate management is possible when using
429
Cusp tip to occlusal plane n Gender
±s Range
14.6±6. 8.6–21.1 3 Male
-0.4±16.6 -12–11.4 2 Female
Cusp tip to frontal plane n Gender
±s Range
2.49±2.75 0.8–5.7 3 Male
6.6±6.63 1.9–11.3 2 Female
three-dimensional images set[23].
Tomasi et al reported the reliability of measure-
ments performed on CBCT images independently from
object position, examiner’s experience and high repro-
ducibility in repeated measurements settings[24].
Santos et al in their study concluded that CBCT
showed reliable and reproducible linear measurements
between inter examiner and intra examiner without sig-
nificant differences[25].
Images obtained from the CBCT provide clear
simulation images of the location of the impacted ca-
nines for the oral surgeon, which will result in less inva-
sive surgery as they work to either expose or extract the
impacted canines. For the orthodontic clinician, CBCT
provides a better knowledge of the required mechanics,
force and treatment modality to move the impacted ca-
nines efficiently with fewer complications. CBCT is the
best method until now to diagnose and localize the im-
pacted canines and their possible complications[1, 5, 18–20].
Despite all of these studies, there were no meth-
odological standards to use CBCT in diagnosing and
locating impacted canines[5].
We used the three-dimensional tool in the InVivo
Dental Anatomage software, which has the cephalomet-
ric analysis creation and analysis function because many
studies confirmed the reliability and accuracy of local-
ization of the landmarks in three-dimensional way, and
its superiority to the two-dimensional way. Studies also
concluded that CBCT images can ultimately improve
diagnosis and treatment plans, supply more accurate
management to successful treatment outcomes, and en-
hance patient care[20–32].
The main disadvantage of CBCT is that the radia-
tion dose to which the patients are exposed is relatively
high, but the advantages outweigh the disadvantages and
it is undoubted that CBCT is far more superior to other
techniques.
In our study the results of the type of impactions
confirmed the previous studies in Chinese population
that most of the impactions were located in face and in
midalveolus, and also the incidence of the adjacent root
resorption due to the proximity of the impacted canines[3,
4, 8, 32]
.
In conclusion, CBCT is a very valuable and under-
used form of technology. When utilized correctly, and
after becoming accustomed to having CBCT measure-
ment values, the oral surgeon and orthodontic clinician
will be able to effectively determine and localize the im-
pacted canines relative to the surrounding structures and
clinical three planes. Due to the accuracy of the informa-
tion provided by CBCT, it may ultimately lead to better
 430
management.
Conflict of Interest Statement
The authors declare that there is no conflict of interest
with any financial organization or corporation or individual that
can inappropriately influence this work.
REFERENCES
1 Thilander B, Jakobsson SO. Local factors in impaction of
maxillary canines. Acta Odontol Scand, 1968,26(1-2):
145-168.
2 Preda L, La Fianza A, Di Maggio EM, et al. The use of
spiral computed tomography in the localization of im-
pacted maxillary canines. Dento Maxillofac Radiol,
1997,26(4):236-241
3 Walker L, Enciso R, Mah J. Three-dimensional localiza-
tion of maxillary canines with cone-beam computed to-
mography. Am J Orthod Dentofacial Orthop, 2005,128(4):
418-423
4 Mason C, Papadakou P, Roberts GJ. The radiographic
localization of impacted maxillary canines: a comparison
of methods. Eur J Orthod, 2001,23(1):25-34
5 Rossini G, Cavallini C, Cassetta M, et al. Localization of
impacted maxillary canines using cone beam computed
tomography. Review of literature. Ann Stomatol (Roma),
2012,3(1):14-18
6 Elefteriadis JN, Athanasiou AE. Evaluation of impacted
canines by means of computerized tomography. Int J
Adult Orthodon Orthognath Surg, 1996,11(3):257-264
7 Ericson S, Kurol J. Resorption of maxillary lateral inci-
sors caused by ectopic eruption of the canines. Am J Or-
thod Dentofacial Orthop, 1988,94(6):503-513
8 Peck S, Peck L, Kataja M. The palatally displaced canine
as a dental anomaly of genetic origin. Angle Orthod,
1994,64(4):249-256
9 Jacobs SG. The impacted maxillary canine. Further ob-
servations on aetiology, radiographic localization, pre-
vention/interception of impaction, and when to suspect
impaction. Aust Dent J, 1996,41(5):310-316
10 Montelius GA. Impacted teeth. A comparative study of
Chinese and Caucasian dentitions. J Dent Res, 1932,12(6):
931-938
11 Bishara SE. Impacted maxillary canines: A review. Am J
Orthodentofacial Orthop, 1992,101(2):159-171
12 Ericson S, Kurol J. Incisor root resorption due to ectopic
maxillary canines imaged by computerized tomography:
a comparative study in extracted teeth. Angle Orthod,
2000,70(4):276-283
13 Ericosn S, Bjerklin K, Falahat B. Does the canine dental
follicle cause resorption of permanent root? A computed
tomography study of erupting maxillary canines. Angle
Orthod, 2002,72(2):95-104
14 Ericson S, Bjerklin K. The dental follicle in normally and
ectopically erupting maxillary canines: a computed to-
mography study. Angle Orthod, 2001,71(5):333-342
15 Waitzman AA, Posnick JC, Armstrong DC, et al. Cranio-
facial skeletal measurements based on computed tomo-
graphy: part Ⅱ. Normal values and growth trends. Cleft
Palate Craniofac J, 1992,29(2):118-128
16 Ericson S, Kurol J. CT diagnosis of ectopically erupting
maxillary canines—a case report. Eur J Orthod,
1988,10(1):115-121
17 Bodner L, Bar-Ziv J, Becker A. Image accuracy of plain
film radiography and computerized tomography in as-
J Huazhong Univ Sci Technol［Med Sci］ 34(3):2014
sessing morphological abnormality of impacted teeth. Am
J Orthod Dentofacial Orthop, 2001,120(6):623-628
18 Boeddinghaus R, Whyte A. Current concepts in maxilla
facial imaging. Eur J Radiol, 2008,66(3):396-418
19 Lou L, Lagravere MO, Compton S, et al. Accuracy of
measurements and reliability of landmark identification
with computed tomography (CT) techniques in the max-
illofacial area: a systematic review. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod, 2007,104(3):402-411
20 Berco M, Rigali PH Jr, Miner RM, et al. Accuracy and
reliability of linear cephalometric measurements from
cone-beam computed tomography scans of a dry human
skull. Am J Orthod Dentofacial Orthop, 2009,136(1):
17.e1-17.e9
21 Olszewski R, Reychler H, Cosnard G, et al. Accuracy of
three-dimensional (3D) craniofacial cephalometric land-
marks on a low-dose 3D computed tomograph. Den-
tomaxillofac Radiol, 2008,37(5):261-267
22 Nagpal A, Pai KM, Setty S, et al. Localization of im-
pacted maxillary canines using panoramic radiography. J
Oral Sci, 2009,51(1):37-45
23 Botticelli S, Verna C, Cattaneo PM, et al. Two- versus
three-dimensional imaging in subjects with unerupted
maxillary canines. Eur J Ortho, 2011,33(4):344-349
24 Tomasi C, Bressan E, Corazza B, et al. Reliability and
reproducibility of linear mandible measurements with the
use of a cone-beam computed tomography and two object
inclinations. Dentomaxillofac Radiol, 2011,40(4):
244-250
25 Santos Tde S, Gomes AC, de Melo DG, et al. Evaluation
of reliability and reproducibility of linear measurements
of cone-beam-computed tomography. Indian J Dent Res,
2012,23(4):473-478
26 Ericson S, Kurol J. Resorption of incisors after ectopic
eruption of maxillary canines: a CT study. Angle Orthod,
2000,70(6):415-423
27 Hassan B, Nijkamp P, Verheij H, et al. Precision of iden-
tifying cephalometric landmarks with cone beam com-
puted tomography in vivo. Eur J Orthod, 2013,35(1):
38-44
28 Chien PC, Parks ET, Eraso F, et al. Comparison of reli-
ability in anatomical landmark identification using
two-dimensional digital cephalometrics and
threer-dimensional cone beam computed tomography in
vivo. Dentomaxillofac Radiol, 2009,38(5):262-273
29 Ludlow JB, Gubler M, Cevidanes L, et al. Precision of
cephalometric landmark identification: Cone-beam com-
puted tomography vs conventional cephalometric views.
Am J Orthod Dentofacial Orthop, 2009,136(3):
312.e1-312 .e10
30 Katkar RA, Kummet C, Dawson D, et al. Comparison of
observer reliability of three-dimensional cephalometric
landmark identification on subject images from Galileos
and i-CAT cone beam CT. Dentomaxillofac Radiol,
2013,42(9):20130059
31 Zamora N, Llamas JM, Cibrián R, et al. A study on the
reproducibility of cephalometric landmarks when under-
taking a three-dimensional (3D) cephalometric analysis.
Med Oral Patol Oral Cir Bucal, 2012,17(4):678-688
32 Liu DG, Zhang WL, Zhang ZY, et al. Three dimensional
evaluations of supernumerary teeth using cone-beam
computed tomography for 487 cases. Oral Surg Oral Med
Oral Pathol Oral Radiol Endod, 2007,103(3):403-411
(Received Mar. 4, 2014; revised May 8, 2014)