Three-dimensional Evaluation of Dentoalveolar Parameters in Maxillary Unilaterally Impacted Buccal versus Palatal Canines: A Retrospective Cone Beam Computed Tomography Study

Introduction: The accurate diagnosis and treatment planning of maxillary impacted canines are critical for achieving optimal aesthetic, functional, and periodontal outcomes. Buccal and palatal impactions often exhibit differing aetiologies, spatial characteristics and treatment challenges. Evaluating these differences may provide insights into tailored management strategies thus improving the treatment planning, minimising complications and optimising outcomes. By using Cone Beam Computed Tomography (CBCT) technology, the present study seeks to advance the understanding of the anatomical variations in buccal versus palatal maxillary impacted canines that may help in refining treatment approaches, improving surgical outcomes and reducing potential complications. Aim: The aim of this investigation was to evaluate and compare dentoalveolar parameters of subjects having unilateral buccal, palatal impacted and normally erupted maxillary canines with CBCT. Materials and Methods: The present retrospective observational study was conducted in the Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India, over a period of one year starting from November 2022 to November 2023. Seventy CBCT scan of patients with no congenital deformity, in the age group of 12-16 years of age, of both the genders, having unilateral buccal, unilateral palatal and normal erupted maxillary canines were screened from the existing database of the department, out of which 30 unilateral buccal, 30 unilateral palatal and 10 normal erupted maxillary canines were selected. Statistical comparisons were made using One-way Analysis of Variance (ANOVA) test while comparing unilateral impacted buccal, palatal, and normally erupted maxillary canines. The intergroup comparison was done using independent t-test, and p-value of 0.05. Results: Significant statistical differences (p <0.05) were found between buccal and palatal impacted and normal erupted maxillary canines with respect to the following parameters- buccopalatal alveolar ridge width (p-value 0.001), transverse arch width (p-value 0.001), anterior dentoalveolar height (p-value 0.001), tooth sizearch perimeter discrepancy (p-value 0.001), tooth angulation (p value 0.001), Crown and root Length (p-value 0.001). Significant differences were also found between palatal and buccal impacted maxillary canines when compared individually with relation to the following parameters: buccopalatal alveolar ridge width (p-value 0.001), transverse arch width (p-value 0.01), tooth size-arch perimeter (p-value 0.012), anterior dentoalveolar height (p-value 0.01), tooth angulation (p-value 0.001), crown and root length (p-value 0.001). Conclusion: In the present study, unilateral palatally impacted maxillary canines exhibited increased transverse arch width, tooth size-arch perimeter discrepancy, and root length compared to both buccally impacted and normally erupted canines. Conversely, cases with buccally impacted maxillary canines showed increased buccopalatal alveolar ridge width, anterior dentoalveolar height, and crown length compared to both palatally impacted and normally erupted canines.