Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

08 September 2022: Clinical Research  

Evaluation of Mesiodistal Root Angulation of Permanent Incisors, Canines, and First Pre-Molars by Orthopantomogram Dental Imaging Findings in 296 Children Aged 6–14 Years

Santosh Kumar Goje1ABD*, Bhavna Dave2BEF, Ali Abdel-Halim Abdel-Azim Hassan3ACD, Sarah Ahmed Bahammam4DEF, Hammam Ahmed Bahammam ORCID logo5CDE, Bassam Zidane6BEF, Abdulrahman Alshehri7DEF, Wael Awadh7BDF, Shilpa Bhandi89BCF, A. Thirumal Raj ORCID logo10DEF, Shankargouda Patil1112ACD

DOI: 10.12659/MSM.937833

Med Sci Monit 2022; 28:e937833

0 Comments

Abstract

BACKGROUND: Early pre-eruptive inclination changes of the first premolar (FP) and its associative changes with canine (C) inclination are important to predict canine impaction. This study aimed to evaluate the mesiodistal root angulation of permanent lateral incisors (LI), canines, and first molars by orthopantomogram dental imaging in 296 children ages 6-14 years at a single center in India.

MATERIAL AND METHODS: The total number of participants was 296, with equal numbers of boys and girls divided into 4 age groups: 6-8 years, 8-10 years, 10-12 years, and 12-14 years. Angles between lateral incisor, erupting canine, and first pre-premolar with midline were measured on an orthopantomogram (dental imaging which includes all the teeth with TMJ). The angle between the erupting C with LI and erupting C with FP was measured. Pearson’s correlation was also evaluated between the movement of the erupting canine with lateral incisor and erupting canine with erupting first premolar.

RESULTS: There was a significant difference in the angular values of different age groups (P≤0.05). The movements between LI, C, and FP were moderately correlated boys and girls aged 6-12 years.

CONCLUSIONS: The findings from this study showed that in boys and girls aged 6-14 years, eruption of the upper canine tooth was synchronized with eruption of the LI and FP.

Keywords: Dentition, Mixed, Radiography, Dental, Digital, Tooth Eruption

Background

HYPOTHESIS:

We hypothesized that here is an association of pre-eruptive inclination changes of maxillary FP with inclination changes of maxillary C. This leads to the hypothesis that any abnormal pre-eruptive inclination of the maxillary FP will lead to eruptive problems of the maxillary C. Hence, the study is planned to assess the mesiodistal inclinations of the maxillary permanent C, LI, and the FP in children aged 6–14 years.

AIM:

The aim of the study was to evaluate normal mesiodistal root angulation of permanent incisors, canines, and first molars in 296 boys and girls aged 6–14 years at a single center in India using orthopantomography.

Material and Methods

STATISTICAL ANALYSIS:

The means of the inclination of the LI, C, and FP with the midline were calculated in all groups. We also calculated the means of angular values between C and LI, C, and FP. Significant differences between the inclinations of LI with the midline in all the groups, the inclination of canine with the midline in all the groups, and inclination of FP with the midline in all the groups were evaluated with the ANOVA test. Significant differences between the angle by the long axis of maxillary erupting C and permanent LI in all groups, long axis of erupting maxillary C, and erupting the FP in all the groups were evaluated by ANOVA test. Pearson’s correlation was evaluated between the angles of LI with midline and C with the midline in all the groups. Similarly, Pearson correlation was evaluated between the angles of C with midline and FP with the midline in all the groups. Pearson’s correlation was evaluated between the angle formed by C with LI and C with the FP in all the groups. All these were evaluated in boys and girls. All the parameters were evaluated twice with an interval of 3 weeks by the same trained investigator for evaluating the intra-class correlation coefficient.

Results

We obtained 296 orthopantomographs from children aged 6–14 years. There were 148 boys and 148 girls. Thirty-seven boys were aged 6–8 years, 37 boys were aged 8–10 years, 37 were aged 10–12 years, and 37 were aged 12–14 years. Similarly, 37 girls were aged 6–8 years, 37 girls were aged 8–10 years, 37 were aged 10–12 years, and 37 were aged 1–14 years.

All the measurements were recorded twice with an interval of 3 weeks with the same trained examiner. The intra-class correlation coefficient between the 2 measurements was 0.97. There was no difference between right- and left-side measurements. For analysis, only 1 side value was considered.

There was a statistically significant difference in mean ages of 4 groups in boys (P=0.032) as well as in girls (P=0.026) (Table 1).

The mean angulations of LI with midline in boys were 2.2±0.19° in those aged 6–8 years, 17.1±2.07° in those 8–10 years old, 7.9±0.98° in those 10–12 years old, and 4.2±0.85° in those 12–14 years old, and the differences were statistically significant (P=0.021). Similarly, the C, with midline was 4±0.42° in those 6–8 years, 12.3±1.90 in those 8–10 years, 5.4±0.37° in those 10–12 years, and 3.2±0.76° in those 12–14 years, and the differences were statistically significant (P=0.028). The FP with midline angulation values were 3.2±0.96° in those 6–8 years, 11.7±1.58° in those 8–10 years, 5.1±1.04° in those 10–12 years, and 2.9±0.42° in those 12–14 years, and the differences were statistically significant (P=0.032) (Table 2).

The mean angulations of LI with midline in girls were 2±0.42° in those 6–8 years, 15.3±1.8° in those 8–10 years, 5.3±1.8° in those 10–12 years, and 2.2±0.3° in those 12–14 years, and the differences were statistically significant (P=0.021). Similarly, the angulations of C with midline were 4.2±1.03° in those 6–8 years, 12±2.56° in those 8–10 years, 3.4±0.87° in those 10–2 years, and 1.4±0.87° in those 12–14 years, and the differences were statistically significant (P=0.032). The FP with midline angulation values were 2.9±0.64° in those 6–8 years, 11.8±1.32° in those 8–10 years, 4.8±0.92° in those 10–12 years, and 2.7±0.32° in those 12–14 years, and the differences were statistically significant (P=0.023) (Table 2).

The mean angulations of LI with C in boys were 5±1.17° in those 6–8 years, 25.9±4.09° in those 8–10 years, 10.7±2.12° in those 10–12 years, and 4.2±0.4° in those 12–14 years, and the differences were statistically significant (P=0.28). The mean angulation of FP with C was 2.1±0.51° in those 6–8 years, 2.3±1.02° in those 8–10 years, 3.1±1.56° in those 10–12 years, and 0.7±0.13° in those 12–14 years, and the differences were statistically significant (P=0.034).

The mean angulations of LI with C in girls were 6.3±2.11° in those aged 6–8 years, 19.4±3.53° in those 8–10 years, 8.3±1.05° in those 10–12 years, and 2.4±0.4° in those 12–14 years, and the differences were statistically significant (P=0.29). The mean angulations of the first premolar with C were 2±0.23° in those 6–8 years, 2.2±0.12° in those 8–10 years, 3.4±0.87° in those 10–12 years, and 1.4±0.28° in those 12–14 years, and the differences were statistically significant (P=0.027).

The movement of maxillary permanent LI to the midline angulations and C with midline angulations was moderately correlated and highly significant for all the age groups in boys and girls, except in the age group of 12–14 years. Movement of the FP to the midline angulations and C to midline angulations was also moderately correlated and highly significant in both boys and girls, except in the age group 12–14 years (Table 3).

Angulations of C and LI with angulations of C and FP were moderately correlated and highly significant in boys aged 6–8 years and in girls aged 8–10 years, but the correlations were weak and were not significant in boys 11–12 years and in girls 12–14 (Table 4).

The cusp tip of the erupting canine is in sector 2 in boys aged 6–8 years and in girls 8–10 years of age. In both boys and girls aged 10–12 years, the cusp tip of the erupting canine slowly shifts from sector 2 to sector 1. The erupting cusp tip of the first premolar was always in sector 0 in all groups of boys and girls (Table 5).

Discussion

STUDY LIMITATIONS:

The drawback of this study is its cross-sectional design, as ethics committee approval might not be given for a longitudinal design that requires exposure of children to radiography. The other reason to choose a cross-sectional design is the attrition of the sample, as it may take a prolonged period for a longitudinal study to follow the same subjects from age 6 to 14 years. However, the ideal design for this type of study is a longitudinal study. A longitudinal study with a larger sample may provide more accurate results.

Conclusions

The findings from this study showed that in both boys and girls aged 6–14 years, eruption of the upper canine tooth was synchronized with the lateral incisor and first premolar.

The normal pre-eruptive angles of lateral incisor, canine and first premolar with the midline were evaluated at ages 6–8, 8–10, 10–12, and 12–14 years in boys and girls. The angulations between canine with lateral incisor and canine with the first premolar were also evaluated at ages 6–8, 8–10, 10–12, and 12–14 in boys and girls. There was a moderate correlation between the movement of the canine on the lateral incisor and the first premolar at 6–12 years of age. These normal angular values help the clinician to differentiate a normally erupting canine from an abnormally erupting canine that will become impacted in the future. By identifying an abnormally erupting canine at an early age, the preventive and interceptive treatment procedures will help in preventing future canine impaction.

References

1. Kurol J, Early treatment of tooth-eruption disturbances: Am J Orthod Dentofac Orthop, 2002; 121; 588-91

2. Andreasen JO, Petersen JK, Laskin DM: Textbook and colour atlas of tooth impactions: diagnosis, treatment, prevention, 1997; 126, Copenhagen Denmark, Munskgaard

3. Bishara SE, Ortho D, Impacted maxillary canines: A review: Am J Orthod Dentofac Orthop, 1992; 101; 159-71

4. van der Linden FPG, Transition of the human dentition: Monogr 13 Craniofacial Growth Ser Ann ArborCenter Hum Growth Dev Univ Michigan, 1982; 102-5

5. Ericson S, Kurol J, Radiographic examination of ectopically erupting maxillary canines: Am J Orthod Dentofac Orthop, 1987; 91; 483-92

6. Peck S, Peck L, Kataja M, Site-specificity of tooth agenesis in subjects with maxillary canine malpositions: Angle Orthod, 1996; 66; 473-76

7. Rimes RJ, Mitchell CNT, Willmot DR, Maxillary incisor root resorption in relation to the ectopic canine: A review of 26 patients: Eur J Orthod, 1997; 19; 79-84

8. Alessandri Bonetti G, Incerti Parenti S, De Rinaldis S, Marini I, Association between the inclination of the lateral incisors and the position of the erupting canines on panoramic radiographs: Acta Odontol Scand, 2011; 69; 222-28

9. Baccetti T, Leonardi M, Armi P, A randomized clinical study of two interceptive approaches to palatally displaced canines: Eur J Orthod, 2008; 30; 381-85

10. Baccetti T, Sigler LM, McNamara JA, An RCT on treatment of palatally displaced canines with RME and/or a transpalatal arch: Eur J Orthod, 2011; 33; 601-7

11. Caminiti MF, Sandor GK, Giambattistini C, Tompson B, Outcomes of the surgical exposure, bonding and eruption of 82 impacted maxillary canines: J Can Dent Assoc, 1998; 64; 572-74

12. Becker A, Chaushu S, Success rate and duration of orthodontic treatment for adult patients with palatally impacted maxillary canines: Am J Orthod Dentofac Orthop, 2003; 124; 509-14

13. Caprioglio A, Vanni A, Bolamperti L, Long-term periodontal response to orthodontic treatment of palatally impacted maxillary canines: Eur J Orthod, 2013; 35; 323-28

14. Alessandri Bonetti G, Incerti Parenti S, Daprile G, Montevecchi M, Failure after closed traction of an unerupted maxillary permanent canine: Diagnosis and treatment planning: Am J Orthod Dentofac Orthop, 2011; 140; 121-25

15. Alessandri Bonetti G, Incerti Parenti S, Zanarini M, Marini I, Double vs single primary teeth extraction approach as prevention of permanent maxillary canines ectopic eruption: Pediatr Dent, 2010; 32(5); 407-12

16. Incerti Parenti S, Marini I, Ippolito DR, Alessandri Bonetti G, Preeruptive changes in maxillary canine and first premolar inclinations: A retrospective study on panoramic radiographs: Am J Orthod Dentofac Orthop, 2014; 146; 460-66

17. Liu D, Zhang W, Zhang Z, Localization of impacted maxillary canines and observation of adjacent incisor resorption with cone-beam computed tomography: Oral Surgery Oral Med Oral Pathol Oral Radiol Endodontology, 2008; 105; 91-98

18. Maverna R, Gracco A, Different diagnostic tools for the localization of impacted maxillary canines: clinical considerations: Prog Orthod, 2007; 8; 28-44

19. Alqerban A, Jacobs R, Fieuws S, Willems G, Radiographic predictors for maxillary canine impaction: Am J Orthod Dentofac Orthop, 2015; 147; 345-54

20. Ericson S, Kurol J, Early treatment of palatally erupting maxillary canines by extraction of the primary canines: Eur J Orthod, 1988; 10; 283-95

21. Alessandri Bonetti G, Zanarini M, Incerti Parenti S, Preventive treatment of ectopically erupting maxillary permanent canines by extraction of deciduous canines and first molars: A randomized clinical trial: Am J Orthod Dentofac Orthop, 2011; 139; 316-23

22. Alessandri Bonetti G, Zanarini M, Danesi M, Percentiles relative to maxillary permanent canine inclination by age: A radiologic study: Am J Orthod Dentofac Orthop, 2009; 136; 486e1-e6

23. Stramotas S, Geenty JP, Darendeliler MA, The reliability of crown-root ratio, linear and angular measurements on panoramic radiographs: Clin Orthod Res, 2000; 3; 182-91

24. Lindauer SJ, Rubenstein LK, Hang WM, Canine impaction identified early with panoramic radiographs: J Am Dent Assoc, 1992; 123; 91-97

25. Warford JH, Grandhi RK, Tira DE, Prediction of maxillary canine impaction using sectors and angular measurement: Am J Orthod Dentofac Orthop, 2003; 124; 651-55

26. Shin JH, Oh S, Kim H, Prediction of maxillary canine impaction using eruption pathway and angular measurement on panoramic radiographs: Angle Orthod, 2022; 92; 18-26

Tables

Table 1. Mean age of various groups in boys and girls with a statistical significance of P=0.05 by ANOVA.Table 2. Mean angle of the long axis of the maxillary permanent lateral incisor (LI), maxillary erupting canine (C), and maxillary erupting first premolar (FP) with midline with a statistical significance of P=0.05 by ANOVA in boys and girls.Table 3. Pearson’s correlation between angles of LI with midline and C with midline with statistical significance of P=0.05 by unpaired t test in boys and girls.Table 4. Pearson’s correlation between the angulations of LI with C and C with the FP with statistical significance of P=0.05 with unpaired t test.Table 5. The cusp tips of (C) and (FP) in all age groups of boys and girls.Table 6. Mean angulations of LI with C and FP with canine with a statistical significance of P=0.05 with ANOVA in boys and girls.Table 1. Mean age of various groups in boys and girls with a statistical significance of P=0.05 by ANOVA.Table 2. Mean angle of the long axis of the maxillary permanent lateral incisor (LI), maxillary erupting canine (C), and maxillary erupting first premolar (FP) with midline with a statistical significance of P=0.05 by ANOVA in boys and girls.Table 3. Pearson’s correlation between angles of LI with midline and C with midline with statistical significance of P=0.05 by unpaired t test in boys and girls.Table 4. Pearson’s correlation between the angulations of LI with C and C with the FP with statistical significance of P=0.05 with unpaired t test.Table 5. The cusp tips of (C) and (FP) in all age groups of boys and girls.Table 6. Mean angulations of LI with C and FP with canine with a statistical significance of P=0.05 with ANOVA in boys and girls.

SARS-CoV-2/COVID-19

16 September 2022 : Review article  

Effects of Physiotherapy on Rehabilitation and Quality of Life in Patients Hospitalized for COVID-19: A Rev...

Med Sci Monit In Press; DOI: 10.12659/MSM.938141  

12 September 2022 : Clinical Research  

Effect of Vitamin D Concentration on Course of COVID-19

Med Sci Monit In Press; DOI: 10.12659/MSM.937741  

In Press

30 Sep 2022 : Clinical Research  

Correlation Between Trough Level of Abiraterone and Prostate-Specific Antigen (PSA) Response in Metastatic ...

Med Sci Monit In Press; DOI: 10.12659/MSM.938091  

30 Sep 2022 : Review article  

A Review of the Biological Mechanisms of Dexmedetomidine for Postoperative Neurocognitive Disorders

Med Sci Monit In Press; DOI: 10.12659/MSM.937862  

29 Sep 2022 : Animal Research  

Effect of Antilogous Platelet-Rich Plasma on the Revascularization of Rabbit Prefabricated Flap

Med Sci Monit In Press; DOI: 10.12659/MSM.937718  

26 Sep 2022 : Clinical Research  

Distribution and Determinants of Plasma Homocysteine Levels in a Preconception Population: A Retrospective ...

Med Sci Monit In Press; DOI: 10.12659/MSM.937987  

Most Viewed Current Articles

30 Dec 2021 : Clinical Research  

Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...

DOI :10.12659/MSM.935379

Med Sci Monit 2021; 27:e935379

13 Nov 2021 : Clinical Research  

Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...

DOI :10.12659/MSM.932788

Med Sci Monit 2021; 27:e932788

08 Mar 2022 : Review article  

A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...

DOI :10.12659/MSM.936292

Med Sci Monit 2022; 28:e936292

01 Nov 2020 : Review article  

Long-Term Respiratory and Neurological Sequelae of COVID-19

DOI :10.12659/MSM.928996

Med Sci Monit 2020; 26:e928996

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750