How a computerized tomography examination changed the treatment plans of 80 children with retained and ectopically positioned maxillary canines.

The purpose of this study was to analyze treatment outcome and treatment planning before and after a computerized tomography (CT) investigation of children with retained and ectopically positioned maxillary canines. Intraoral and panoramic radiographs, computerized tomographs, and, in some cases, lateral head films were taken of 80 children with 113 retained maxillary canines. The incisor roots of 39 of the 80 children had some measure of resorption. Forty-two children with retained maxillary canines also had a space deficiency. Diagnosis and a treatment plan were originally based on extraoral and intraoral photos, study models, the anamnesis, the status on the patient's charts, conventional radiography, and, if available, lateral head films. Approximately one year later, the same examiner drew up a new treatment plan based on the same records but with a supplemental CT examination. The treatment plans of 35 (43.7%) of the 80 children were modified to reflect this new information. Of those patients with root resorption on the incisors adjacent to retained canines, more than half (53.8%) of the treatment plans were altered. Without the CT investigation, 11 children would not have been treated for resorption that had exposed the pulp of an incisor root and 13 who had no root resorption on their incisors would have had one or both lateral incisors extracted. The treatment plans of the latter were changed to nonextraction or extraction of premolars. A CT investigation is an important source of information for treatment planning for children with retained or ectopically erupting maxillary canines.