Dental age estimation in Malaysian adults based on volumetric analysis of pulp/tooth ratio using CBCT data

Forensic odontology plays an important role in human identification and dental age estimation is an integral part of this process. The aim of the study was to investigate the association between chronological age and pulp/tooth volume ratio in a Malaysian population (Malays and Chinese) from cone-beam computed tomography (CBCT) scans, enhanced with Mimics software. Three hundred CBCT scans of 153 males and 147 females, aged between 16 and 65 years were divided into 5 age groups. Volumetric analysis of the pulp/tooth ratio was performed in maxillary left canines, maxillary right canines and maxillary right central incisors. Simple linear regression and Pearson correlation analysis indicated the strongest coefficient of correlation (R) values for maxillary right central incisors (0.83) followed by maxillary right canines (0.74) and maxillary left canines (0.73). Fisher’s Z test indicated that dental age estimation is gender independent. The derived regression equations were further validated on an independent group of 126 teeth. The results indicated mean absolute error (MAE) values of 6.48 and 8.58 years for maxillary right central incisors and maxillary canines respectively. It was also noticed that MAE values were higher among the age groups ranging from 46 to 65 years. This study showed that a volumetric change in the pulp cavity with age is a valuable assessment method for dental age estimation among Malaysian population.     

Quantification of secondary dentin formation using dental orthopantomographs in a contemporary Malaysian population

ABSTRACT

The Kvaal method is recommended for age estimation in adults and is based on the analysis of the pulp chamber. Importantly, however, subsequent research has empirically demonstrated that the accuracy of this method varies across global populations. The aim of the current study is, therefore, to examine the relationship between secondary dentin formation and chronological age to establish forensic age estimation standards for a Malaysian population. A total of 300 anonymized dental orthopantomographs of Malaysian individuals, aged between 16 to 69 years were analysed following the Kvaal method. Length and width measurements of the tooth and pulp chamber were acquired in six teeth. Kvaal’s dental ratios were calculated and subsequently used to formulate multiple linear regression models. Intra-observer error was found to be within acceptable standards for all measurements (TEM<1.0, rTEM<5%, R>0.75). A significant negative correlation between chronological age and the Kvaal dental ratios was demonstrated (0.14–0.42). The most accurate model was for maxillary central incisor (SEE ±10.46 years). This study reaffirms the reproducibility of Kvaal’s method in dental radiographs and demonstrates its applicability amongst Malaysians.     

The applicability of Kvaal methods and pulp/tooth volume ratio for age estimation of the Turkish adult population on cone beam computed tomography images

The contraction of the pulp chamber with secondary dentin apposition is a significant morphological dental age predictor in adults. The aim of this study is to evaluate the applicability of Kvaal’s method and pulp/tooth volume ratio on cone-beam computed tomography (CBCT) images and develop a valid method for the Turkish adult population. In this study, 211 single-rooted teeth, extracted for orthodontic and periodontal reasons, of 134 patients with ages ranging from 16 to 71 years, were used. Each sample was scanned using CBCT. According to the reported technique (Kvaal’s method), teeth were analysed on CBCT images. Additionally, pulp/tooth volume ratio was calculated using ITK-SNAP 3.4.0 software. The relationship between age and morphological variables was calculated by the Pearson correlation coefficient. Multiple linear regression models were established for each tooth, age as dependent variable, and morphological variables as independent variables. The determination of coefficients of the Kvaal’s modified regression models were found in a range from 0.296 to 0.550. The pulp volume and the pulp/tooth volume ratio showed statistically significant differences between age groups (p < 0,001). Pulp volume and pulp/tooth volume ratio is a significant index for age. Linear measurement and ratios on CBCT images were insufficient estimates of the age of the Turkish population.     

Discrepancy between chronological age and evaluated dental age using the Demirjian system in Western Australian children

The aims of this work were to assess dental age using the Demirjian system and to evaluate the discrepancy between chronological and dental age among children residing in Western Australia. Forty panoramic radiographs of 5- to 11-year-old children taken at the paediatric clinic of a dental hospital in Western Australia were selected. The developmental stage of each left permanent mandibular tooth excluding the third molar was assessed by three trained examiners. Estimated dental age using the Demirjian system was compared with the chronological age of each child. The accuracy of the Demirjian system in this group of children was 42.5%. The difference between chronological age and dental age was significant (t = 4.066, df = 39, p < 0.001). Dental age estimation for Caucasian children had greater accuracy (χ² = 5.013, df = 1, p = 0.025). Gender and orthodontic concerns were not related to the accuracy of the Demirjian system (p ≥ 0.481). The discrepancy between chronological and dental age using the Demirjian system was significant when assessing the Western Australian population although it was more accurate for Caucasian children. The accuracy was similar between subjects with and without orthodontic concerns.     

Quantification of secondary dentine formation from orthopantomograms—a contribution to forensic age estimation methods in adults

The accuracy of most age determination methods in adults is unsatisfactory and therefore more precise methods are required. Teeth provide several useful points about an individuals age. With advancing age secondary dentine is deposited along the wall of the dental pulp chamber leading to a reduction in the size of the pulp cavity. These age-related changes can be determined and measured from dental radiographs. The aim of this study was to explore if measurements of the size of the pulp cavity performed on orthopantomograms can be used for individual age estimation. Measurements were made digitally for 6 types of teeth from orthopantomograms of 168 individuals aged between 14 and 81 years old. To compensate for errors due to the technique of radiography—for instance differences in angulation—ratios of distances were calculated: pulp/root length, pulp/tooth length and pulp/root width at three different root levels. The width ratios of the pulp cavity showed significant correlation to the chronological age and the coefficient of determination (r²) was highest in the upper lateral incisors (r²=0.913) when an exponential or a logistic regression model was constructed. At the same distance with a linear regression model the coefficient of determination (r²) reached 0.839.     

Alveolar bone loss around incisors in Class I bidentoalveolar protrusion patients: a retrospective three-dimensional cone beam CT study

Objectives

The aim of this study was to test the null hypothesis that there is no difference in the alveolar bone thickness, bone loss or incidence of fenestrations between upper and lower incisors in skeletal Class I bidentoalveolar protrusive patients before orthodontic treatment.

Methods

Three-dimensional (3D) cone beam CT (CBCT) images were taken of 24 patients from the Republic of Korea (17 females and 7 males). Reformatted CBCT images were used to measure labial and lingual alveolar bone thickness (ABT) of the 4 upper incisors and 4 lower incisors of the 24 patients (total n = 192 incisors) at every 1/10 of root length (Level 0, cementoenamel junction (CEJ) area; Level 10, root apex area) as well as alveolar bone area (ABA) and alveolar bone loss (%BL) rate to dental root length. The numbers of fenestration teeth were also tallied.

Results

All anterior teeth were supported by <1 mm of ABT on the labial surfaces up to root length Level 8. ABA was statistically greater on the lingual aspect than the labial aspect in lower incisors. The %BL was 26.98% in the lower labial region, 19.27% in upper labial aspect and most severe on the lower lingual plate 31.25% compared with the labial plate. There were no significant differences in %BL between subgroups when categorized by sex or age. Fenestrations were 1.37 times more frequent on lower incisors (37) than upper incisors (27).

Conclusion

The null hypothesis was rejected, confirming that incisor periodontal support is poor and alveolar bone loss is severe even prior to the start of orthodontic treatment. Careful diagnosis using 3D CBCT images is needed to avoid iatrogenic degeneration of periodontal support around anterior teeth, particularly in the lower lingual bone plate region.     

Análisis estructural cuantitativo del hueso alveolar trabecular de la mandíbula en tomografía computarizada multidetector: diferencias por tipo y estado dentario

Background and objectiveThere is a lack of quantitative measures of the quality of alveolar trabecular bone, an important factor in implantology. This study aimed to develop a method of objectively assessing the quality of trabecular bone by means of image processing and structural analysis of multidetector computed tomography images and to establish differences between tooth types and tooth presence/absence.Materials and methodsWe analyzed 20 patients who underwent multidetector computed tomography to evaluate mandibular bone and tooth positioning. Image analysis included automatic segmentation of the mandible, obtainment of sections perpendicular to the dental arch, and structural analysis of the trabecular bone in each section. We calculated the ratio between the volume of bone and the total volume of the section, the thickness, the trabecular number, and the mean attenuation in Hounsfield units. We analyzed the differences among different tooth types (incisors, canines, premolars, and molars) and between present and absent teeth.ResultsWe found statistically significant differences between different tooth types and between sections in which teeth were present or absent. Incisors had a greater ratio of trabecular bone; the ratio of trabecular bone progressively decreased from the incisors to the canines, premolars, and molars. The ratio of trabecular bone was greater in sections in which teeth were absent than in those in which teeth were present.ConclusionsThe method allows to quantify the structural properties of alveolar bone from multidetector computed tomography images. Our results provide an objective picture of the bone substrate that can be useful for planning and following up dental implant procedures.     

Age estimation by pulp/tooth ratio in lateral and central incisors by peri-apical X-ray

Since 2004, several papers on the analysis of the apposition of secondary dentine have been published. The aim of this paper was to study a sample of peri-apical X-ray images of upper and lower incisors, both lateral and medial, to examine the application of pulp/tooth area ratio as an indicator of age. A sample of 116 individuals, 62 men and 54 women, aged between 18 and 74 years, was studied. Data were fitted with age as a linear function of the pulp/tooth ratio of incisors. The total variance explained by the regression equation ranged from 51.3% of age, when lower lateral incisors were used as explanatory variable, to 81.6% when upper lateral incisors were used. The accuracy of the corresponding regression model yielded ME = 8.44 and 5.34 years, respectively. These results show that, although incisors are less reliable than canines or lower premolars, they can be used to estimate age-at-death when the latter are absent.     

Three-dimensional visualization of composite fillings for dental identification using CT images

Objectives

This study aimed to discriminate between enamel and composite resins by differences in Hounsfield units shown on 16 section multidetector CT (MDCT) images taken of unidentified bodies.

Methods

First, we determined the Hounsfield units of composite resins in 15 extracted human teeth. We then filled a single cavity prepared in each of the teeth with one of five different types of composite resins, and scanned the teeth using our routine post-mortem CT protocol for the head and neck. Obtained data were transferred to a radiological workstation and reconstructed. Furthermore, post-mortem CT images of the head of three unidentified bodies were reconstructed in the same manner.

Results

Four types of composite resins containing radio-opaque fillers showed a constant value of 4000 HU, and one radiolucent composite resin showed values in the range of 660–800 HU in the extracted teeth. Pixels at 4000 HU indicated that the composite resins were selected and visualized as three-dimensional colour images. Composite resins could be visualized on reconstructed images of the three unidentified bodies, and the sites visualized matched those noted on the forensic dental charts.

Conclusions

Discriminating enamel and composite resins containing radio-opaque materials was difficult because of their similar Hounsfield unit values. However, we did succeed in visualizing the composite resins despite limitations of the CT scale. CT reconstructed images can contribute to dental identification, particularly in cases where it is difficult to detect composite resins on external investigation, and these images can be prepared during routine dental identification work.     

Development and evaluation of a standardized method and atlas for contouring primary and permanent dentition

Objectives:

Radiation toxicity of the dentition may present significant treatment-related morbidity in the paediatric head and neck cancer population. However, clear dose–effect relationships remain undetermined and must be predicated upon accurate structure delineation and dosimetry at the individual tooth level. Radiation oncologists generally have limited familiarity or experience with relevant dental anatomy.

Methods:

We therefore developed a detailed CT atlas of permanent and primary dentition. After studying this atlas, five radiation oncology clinicians delineated all teeth for each of eight different cases (selected for breadth of dental maturity and anatomical variability). They were asked to record confidence in their contours on a per-tooth basis as well as the duration of time required per case. Contour accuracy and interclinician variability were assessed by Hausdorff distance and Dice similarity coefficient. All analyses were performed using R v. 3.1.1 and the RadOnc v. 1.0.9 package.

Results:

Participating clinicians delineated teeth with varying degrees of completeness and accuracy, stratified primarily by the age of the subject. On a per-tooth basis, delineation of permanent dentition was feasible for incisors, canines, premolars and first molars among all subjects, even at the youngest ages. However, delineation of second and third molars was less consistent, commensurate with approximate timing of tooth development. Within each tooth contour, uncertainty was the greatest at the level of the dental roots.

Conclusions:

Delineation of individual teeth is feasible and serves as a necessary precursor for dental dose assessment and avoidance. Among the paediatric radiation oncology community in particular, this atlas may serve as a useful tool and reference.     

A new age estimation procedure based on the 3D CBCT study of the pulp cavity and hard tissues of the teeth for forensic purposes: A pilot study

BackgroundDental age of adults can be estimated by the analysis of the progressive physiological and degenerative phenomena which affect dental tissues. The pulp-dentinal complex is one of the dental structures that show modifications related to age, mainly resulting in the reduction of the pulp chamber volume due to the continual deposition of secondary dentin. The study aims to evaluate the accuracy of a simple and conservative method for estimating the age of adults based on CBCT (Cone Beam Computed Tomography) analysis of the narrowing of the pulp chamber caused by secondary dentin deposition.Materials and methodsTwo operators have randomly analyzed 148 CBCT (Scanora 3D – Soredex) and considered the upper left central incisor. The sample consists of 57 male individuals and 91 females aged between 10 and 80 years. This research was designed to simplify dental volume measurement through geometric approximation of the different parts of the tooth. The root and the pulp were assimilated to elliptical based cones and the crown to an elliptical based truncated cone and these volumes were calculated through measurements using Osirix^® software (OnDemand 3D software CyberMed Inc.). The ratio between the pulp volume and the hard tissues volume (PHr) was assumed as a variable according to the following formula: PHr = V pulp/V ht. The proposed method based on geometric approximation of dental volumes was validated comparing volumes calculated using CBCT with physical measurements of real volumes of 3 teeth.ResultsThe physical measurements revealed that the measurement procedures using CBCT produce a regular underestimation of real volumes, that ranges from 53% to 70%. Since the error occurs quite regularly both for pulp and for hard tissue volume, it tends to be eliminated when their ratio is considered. The PHr was statistically significant (p-value < 0.001) as a predictor for age estimation. The gender variable was not significantly correlated with age (p = 0.7694) and it was, therefore, excluded from the linear regression formula for age estimation: Age = −64.14 – 32.00*Ln PHr. The age cohorts between 30 to 59 years showed the highest accuracy in age prediction (residual errors 0.71, 2.88, and −5.86 years), whilst for other age cohorts the estimation error is similarly reported by applying other dental methods.ConclusionThe outcomes of this pilot study show that the narrowing of the pulp chamber is a reliable parameter for estimating the age of adults, and that CBCT is an easy and conservative approach that allows accurate calculation of tooth volumes. The proposed approach based on geometric approximation of upper central incisor volumes measured by CBCT remarkably reduced the operating time in comparison to other more complex and expensive techniques. The validation procedure in which real volumes are compared with those calculated using CBCT supports the accuracy of the experimented approach and the good inter-examiner agreement (ICC 0.99) demonstrates that the method is highly reproducible.     

Age determination of adult individuals by three-dimensional modelling of canines

Accurate age determination is fundamental in both forensic medicine and anthropology. Many methods that relate dental characteristics to adult age have been proposed, but there is still no simple and reliable method that does not damage the study material. The aim of this work was to propose a relevant and practical technique for determining age in adults that could be used in both living and deceased individuals. The sample was composed of 210 CT scans from individuals aged from 15 to 85 years old, with four healthy canines present in the mouth. The 840 canines were modelled using Mimics® 10.01 software. The pulp volume/total volume ratio ×100 was determined for each tooth. Seven mathematical models, corresponding to all possible real situations, were determined by the weighted least squares method and ranked in order of relative performance. The adequacy of the seven models to the data was very high with the regressions proposed (0.915?<?R ² _adjusted?<?0.964). Ranked in order of performance, the maxillary model was the most powerful of the seven models for age determination, followed by the 4 canines model, the 13 model and the 23 model.     

Forensic age estimation using the eruption of the second permanent mandibular molar: determining age over 14 years-old

Little is known about the role of the second molar eruption in forensic age estimation; however, in countries where the legal age is 14-years-old, it can provide important information. This study aims to analyse whether the eruption stages of the second mandibular molar can be used for forensic age estimation purposes. The eruption stage of the second left mandibular molar was assessed and correlation between age and stage of eruption was evaluated using Spearman rank order correlation. A Chi-square test was used to assess the correlation between age equal or superior to 14 and stage C or D attainment. The level of significance was defined as p<0.05. Stage C and D attainment and age 14 were significantly related in both sexes (p<0.001). Still, stage 3 was attained by 37% and 44.4% of the males and females younger than 14 years, respectively; stage 4 was attained by 14.8% and 25.6% of the males and females younger than 14 years, respectively. Second molar emergence, particularly stage D, can be used as a dental age indicator. When stage D is attained, particularly in males, there is strong suggestion of age over 14 years. However, other markers should also be used.     

Age estimation of teenagers from Monterrey (Mexico) by the evaluation of dental mineralization after multi-slice helical computed tomography

Current social conditions require more accurate methods to determine the age of people, either living or deceased. The aim of this study was to determine chronological age by measuring the mineralization of third molars. Volunteers (n = 137), aged between 14 and 22 years and of either gender, were recruited from north-eastern Mexico. Sampling was probabilistic and at random. The mineralization stage of third molars was evaluated with the use of multi-slice helical computed tomography and the Mincer-modified Demirjian amended scale. The correlation coefficient, mean difference and linear estimation were determined. There was a linear correlation between age and the mineralization of third molars. Third molars of adults had a degree of mineralization above Demirjian stage F, whereas the third molars of minors had stages between A and F. Hence, a method was obtained to determine the chronological age from the evaluation of dental mineralization of third molars by multi-slice helical tomography. These results are useful as a diagnostic support in forensic dentistry.     

Validity of a modified Demirjian system based on an Australian dataset – simple maturity score in age estimation

This pilot study is a validation of a modified Demirjian’s System developed for the Australian population by Blenkin and Evans. The study sample comprised orthopantomographs of 230 individuals aged 2.5 to 14.5 years. Seven right mandibular teeth (excluding the wisdom tooth) were assessed and graded according to the Demirjian’s stages of tooth development. Corresponding modified numeric scores for the stages were summed to form a simple maturity score from which age estimates were derived. The mean difference between the estimated and chronological age for girls was 0.02 years, 95% CI [-0.13, 0.17]. Paired-sample t-test results found this difference not to be statistically significant p = 0.81, <0.05. For boys, the method underestimated the age with a mean difference of –0.24 years 95% CI [–0.4, –0.08]. Paired t-test found this to be significantly different (p = 0.003). This study found that the modified Demirjian’s System of Blenkin and Evans is valid for use in the Australian population.     

Comperative evaluation of Nolla,Willems and Cameriere methods for age estimation of Turkish children in the Central Black Sea Region: A preliminary study

PurposeSince dental age estimation methods' accuracy and reliability levels differ in each society, the method should be appropriate for societies. This study aims to evaluate the applicability of Nolla, Willems, and Cameriere methods to Turkish children in the Central Black Sea Region.Material and methodThis study was conducted based on the panoramic radiographs of 400 children between the ages of 6–14 years admitted to Tokat Gaziosmanpaşa University Faculty of Dentistry, Department of Pediatric Dentistry for examination between 2016 and 2020. Nolla, Willems, and Cameriere methods estimated dental age on the selected panoramic radiographs. While 14 teeth in the left mandible and maxilla were evaluated for Nolla method, seven teeth in the left mandible were evaluated for Willems and Cameriere methods. Data were analyzed using IBM SPSS V23. The Pearson correlation coefficient was used to analyze the relationship between the chronological age (CA) and dental age (DA), and the paired sample t-test was used to analyze the difference.ResultsA statistically significant difference was found between CA-Nolla dental age (p = 0.002), CA-Willems dental age (p < 0.001), and CA-Cameriere dental age (p = 0.033) in boys. The mean differences between dental age and chronological age in boys were −0.24 years in the Nolla method, +0.49 years in Willems method, and −0.17 years in the Cameriere method. A statistically significant difference was found between CA-Nolla dental age (p = 0.001) and CA-Willems dental age (p < 0.001) in girls. The mean differences between dental age and chronological age in girls were −0.27 years in the Nolla method, +0.76 years in the Willems method, and −0.1 years in the Cameriere method.ConclusionIn this study method providing closest estimation for chronological age among children aged 6–14.99 that were examined in Central Black Sea Region, was the Cameriere method in both girls (79.9%) and boys (80.6%), followed by Nolla method and Willems method, respectively.     

Validity of different dental age estimation methods in Pakistani orthodontic patients

This research aims to evaluate the validity of Demirjian’s (1973), Nolla’s (1960) and Willem’s (2001) methods of dental age (DA) estimation in Pakistani orthodontic patients (8–16.9 years). It also addresses the validity of these methods in determining dental maturity across the gender and compares the difference between original Demirjian tables (based on French-Canadian standards) and Pakistani tables formulated by Sukhia et al. (2012). Orthopantomograms of 403 subjects (males?=?176, females?=?227) were examined for DA assessment by different methods. Paired t-test and Wilcoxon signed-ranked tests were used to determine significant differences between mean dental and chronological age among different age groups. Correlation between DA and CA were assessed by the Spearman’s correlation (p?=?≤0.05). Nolla’s method under-estimated the DA by 1.00 ± 1.54 in males and over-estimated by 0.21 ± 1.64 in females. DA was significantly advanced using Pakistani tables (males?=?0.32 ± 1.17, females?=?0.38 ± 1.33 years) and Willem’s method (males?=?0.31 ± 1.09, females?=?0.29 ± 0.48 years). DA correlated better with CA using Pakistani tables compared with the French-Canadian standards. Earlier dental maturation was reported in females compared with males using Demirjian’s and Nolla’s methods. Strong correlations were found between CA and DA according to all methods (p < 0.001). Overall, Willem’s method was identified as the most valid method for DA estimation in the Pakistani sample.     

Dental identification in routine forensic casework: clinical and postmortem investigations

The aim of this study was to examine the factors which may disturb dental identification of unknown human remains and the practical value of dental evidence in routine forensic casework, including the changes due to dental treatment and postmortem interference. In the investigation of changes due to dental treatment on 696 patients' dental history at two clinics, increase of the number of dental restorations was the greatest in the initial 1-2 years. This finding suggests that dental treatments performed in early period after initial examination contributes more to forensic dental identification than those performed afterwards. The lower anterior teeth (incisors and canines) remained relatively unchanged for years compared with other teeth. The molars appeared to be more frequently restored at a relatively younger age and more frequently missing in the elderly. The investigation of 260 unknown remains in 971 forensic autopsy cases during a period of seven years (1992-1998) at our institute indicated the particular usefulness of dental evidence in cases where the candidates were identified from some other evidence, and usually in cases having a postmortem period corresponding to the obligatory preservation term for the clinical dental records and radiographic films. There were non-identity in the status of dental treatments between ante-mortem dental findings due to additional treatments received after the last day of examination recorded in the corresponding clinical dental records. Postmortem damage from decomposition and fire was more frequently observed in the anterior teeth. These observations indicate that precise documentation of dental evidence including postmortem deterioration and the establishment of a well-organized dental database of missing persons together with a suitable screening system is required to more effectively utilize dental evidence in routine forensic casework.     

Age estimation in children by measurement of open apices in teeth

This paper concerns a method for estimating the age of children based on their teeth. The sample consisted of 455 Italian white children (213 boys, 242 girls) aged between 5 and 15 years. The purpose of the present investigation was to present a method for assessing chronological age based on the relationship between age and measurement of the open apices in teeth. Pearson’s correlation coefficients between age and these variables showed that the correlations between age and the open apices in teeth were significant and negative. Furthermore, gender and the number of teeth with the apical end of the root canals completely closed (N ₀) showed a significant correlation with chronological age. With the aid of a stepwise multiple regression model, a linear relationship between open apices, N ₀, and age was shown. Statistical analysis indicated that these morphological variables explain 83.6% of the variations in estimated chronological age. The median of residual errors between the actual and estimated ages was −0.035 years [interquartile range (IQR)=1.18 years].     

The assessment of impacted maxillary canine position with panoramic radiography and cone beam CT

Objective

The aim of this study was to correlate the position of impacted maxillary canines on panoramic radiography with cone beam CT (CBCT) and analyse the labiopalatal position of canines and root resorption of permanent incisors in CBCT according to the mesiodistal position of canines on panoramic radiographs.

Methods

This study was a retrospective radiographic review of 63 patients with 73 impacted maxillary canines. The mesiodistal position of the canine cusp tip was classified by sector location and analysed on 73 impacted canines from 63 panoramic radiographs. The labiopalatal position of the impacted canines and root resorption of permanent incisors were evaluated with CBCT. The sector location on panoramic radiographs was compared with the labiopalatal position of impacted maxillary canines on CBCT. The statistical correlation between panoramic and CBCT findings was examined using the χ² test and the Fisher''s exact test.

Results

Labially impacted canines in CBCT were more frequent in Panoramic Sectors 1, 2 and 3, mid-alveolus impacted canines were more frequent in Sector 4 and palatally impacted canines were more frequent in Sector 5. There was a statistically significant association between the panoramic sectors of the impacted canines and the labiopalatal position of the canines (p < 0.001). Root resorption of permanent incisors showed a significant difference according to sector location (p < 0.001) and was observed in Sectors 3, 4 and 5.

Conclusions

This study suggests that the labiopalatal position of impacted canines and resorption of permanent incisors might be predicted using sector location on panoramic radiography.