Residents’ journal review

Panoramic radiographs for identifying supernumerary teeth

Anthonappa RP, King NM, Rabie AB, Mallineni SK. Reliability of panoramic radiographs for identifying supernumerary teeth in children. Int J Paediatr Dent 2012;22:37-43

Although panoramic radiographs are a noninvasive method for providing comprehensive information regarding the maxillomandibular region, the area of interest might be outside the focal trough and become blurred or distorted. The goal of this study was to assess the reliability of panoramic radiographs for identifying supernumerary teeth and the difference in ability of identifying supernumerary teeth based on the examiner’s dental training level. Seventy-five panoramic radiographs were randomly selected. An answer key was compiled from treatment and radiographic records by the primary investigator. Eighteen examiners were enrolled: 9 were new graduates who had just finished their basic dental training, and the other 9 were pediatric residents with 1 to 2 years of clinical experience. Each examiner was instructed to identify all dental abnormalities in 25 panoramic radiographs. The Fisher exact test was used for descriptive statistics; Fleiss kappa and Cohen kappa were used to evaluate interexaminer and intraexaminer reliabilities. The overall sensitivity, specificity, positive predictive value, and negative predictive value for identifying patients with supernumerary teeth by using panoramic radiographs were 50%, 97.2%, 90.6%, and 83.6%, respectively. The sensitivity figures for new graduates and pediatric residents were 39.2% and 60.8%, respectively; these were significantly different ( P <0.05). The authors concluded that low sensitivity and positive predictive value make panoramic radiographs unreliable for identifying supernumerary teeth. Higher levels of dental training are essential for identifying supernumerary teeth. This article emphasized the necessity for a more reliable diagnostic tool for identifying supernumerary teeth.

Reviewed by Ju-Han Chang

Duration and cost of treatment for palatally displaced maxillary canines

Bazargani F, Magnuson A, Dolati A, Lennartsson B. Palatally displaced maxillary canines: factors influencing duration and cost of treatment. Eur J Orthod 2012; Jan 24 [Epub ahead of print]

The prevalence of maxillary impacted canines is approximately 2% to 3% in white people. Palatally displaced canines are more common than labially displaced canines and, when present, significantly increase the length of orthodontic treatment. In this retrospective study, the authors attempted to find a relationship between the initial position of palatally displaced canines and the duration of treatment, and estimate the cost of treatment. Sixty-six consecutive patients, treated over a 9-year period, who required surgical exposure and forced eruption of at least 1 palatally displaced canine were selected. Panoramic radiographs were used to assess initial canine position, and 3 independent variables were measured: distance from the canine crown to the occlusal plane, canine inclination to the midline, and zone of the canine crown position. The zones were marked on the radiograph, extending mesially from zone 1 at the canine position to zone 5 at the midline. After adjustment for background variables, treatment time increased on average by 1.2 months per millimeter of increased distance of the palatally displaced canine from the occlusal plane. The results also showed .19 months of increased treatment time for every degree of increased inclination of the palatally displaced canine from the midline. The total treatment durations averaged 17 months for canines displaced in zone 1 or 2, 20 months for those in zone 3, and 27 months for those in zone 4 or 5. As expected, the authors found the cost to be significantly higher for patients with palatally displaced canines because of increased treatment times and surgical fees, and additional dental laboratory fees. Although this study was retrospective, the authors suggested criteria that might be useful when studying panoramic radiographs to assist orthodontists in more accurately estimating treatment times for patients with palatally displaced canines.

Reviewed by Josh Barta

Duration and cost of treatment for palatally displaced maxillary canines

Bazargani F, Magnuson A, Dolati A, Lennartsson B. Palatally displaced maxillary canines: factors influencing duration and cost of treatment. Eur J Orthod 2012; Jan 24 [Epub ahead of print]

The prevalence of maxillary impacted canines is approximately 2% to 3% in white people. Palatally displaced canines are more common than labially displaced canines and, when present, significantly increase the length of orthodontic treatment. In this retrospective study, the authors attempted to find a relationship between the initial position of palatally displaced canines and the duration of treatment, and estimate the cost of treatment. Sixty-six consecutive patients, treated over a 9-year period, who required surgical exposure and forced eruption of at least 1 palatally displaced canine were selected. Panoramic radiographs were used to assess initial canine position, and 3 independent variables were measured: distance from the canine crown to the occlusal plane, canine inclination to the midline, and zone of the canine crown position. The zones were marked on the radiograph, extending mesially from zone 1 at the canine position to zone 5 at the midline. After adjustment for background variables, treatment time increased on average by 1.2 months per millimeter of increased distance of the palatally displaced canine from the occlusal plane. The results also showed .19 months of increased treatment time for every degree of increased inclination of the palatally displaced canine from the midline. The total treatment durations averaged 17 months for canines displaced in zone 1 or 2, 20 months for those in zone 3, and 27 months for those in zone 4 or 5. As expected, the authors found the cost to be significantly higher for patients with palatally displaced canines because of increased treatment times and surgical fees, and additional dental laboratory fees. Although this study was retrospective, the authors suggested criteria that might be useful when studying panoramic radiographs to assist orthodontists in more accurately estimating treatment times for patients with palatally displaced canines.

Reviewed by Josh Barta

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Apr 8, 2017 | Posted by in Orthodontics | Comments Off on Residents’ journal review
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