Effectiveness of impacted and supernumerary tooth diagnosis from traditional radiography versus cone beam computed tomography

The purpose of this study was to determine if cone beam computed tomography (CBCT) is more effective than traditional radiography (TR) in diagnosing pediatric dental clinical cases involving impacted and supernumerary teeth. Methods: Surveys were given to 10 pediatric dental faculty and 10 pediatric dental residents after viewing 8 clinical cases in either CBCT or TR in which the patient presented with pathology (impaction or supernumerary) in the anterior maxilla. The surveys asked for pathology diagnosis, location, and identification of root resorption, as well as questions about the usefulness of the radiographic mode in treatment planning. Results: A statistically significant difference in CBCT vs. TR viewed cases was found with CBCT statistically better (P<0.05) for pathology location, determining root resorption, usefulness, adequacy in treatment planning, and was the overall recommended mode. More faculty were able to correctly identify the pathology location (P=0.034), while more residents believed they could determine presence of root resorption P=0.029). For impacted versus supernumerary cases, more pathology was correctly located when viewed in CBCT mode (P<0.05). No statistical significance in diagnosing the presence of pathology for all cases was found. Conclusions: CBCT and TR were effective in the initial diagnosis of pathology in the cases presented. CBCT, however, provides more information on the location of pathology, the presence of root resorption, and treatment planning. The pediatric dental community can benefit from the amount of additional information provided by CBCT. The benefits of CBCT imaging must be weighed against the radiation risk to the pediatric patient and the complexity of the pathology.