Cone-beam computed tomography as a surgical guide to impacted anterior teeth

Abstract

Surgical procedure for removal of impacted teeth is a challenge for clinicians as it involves accuracy in
the diagnosis and localization of the dental elements. The cone-beam computed tomography (CBCT),
compared to the conventional radiography, has a greater potential to provide complementary
information because of its three-dimensional (3D) images, reducing the possibility of failures in
surgical procedures. Two 10-year-old boys presented with aesthetic issues associated with the
juxtaposition of ectopic teeth with the permanent ones. Both two-dimensional and 3D preoperative
radiographic diagnostic sets were produced. The occlusal and panoramic radiographs were not
enough for proper localization of impacted incisors. Thus, the CBCT was used as a surgical guide.
After 2 years of longitudinal following, no lesion was recorded, and the orthodontic treatment
has proven successful. In all cases, CBCT contributed to both diagnosis and correct localization
of supernumerary teeth, aiding the professional in the treatment planning, and consequently in
the clinical success. The surgeries were completely safe, avoiding damage in noble structures, and
providing a better recovering of the patients.

Key Words: Cone-beam computed tomography, diagnosis, impacted tooth