Assessment of bone density around impacted maxillary canine teeth by gray value analysis on cone-beam computed tomography images

Abstract

Background and aim This study evaluated the relationship between local alveolar bone density and maxillary canine impaction using gray values (GVs) obtained from cone-beam computed tomography (CBCT) scans. Materials and methods In this retrospective cross-sectional study, CBCT images of 74 patients (58 females and 16 males; mean age: 25 years) retrieved from a single private radiology center were evaluated under standardized conditions. Impacted and erupted maxillary canines were selected based on the defined clinical and radiographic criteria. GVs were measured in the cervical and apical regions of the alveolar bone adjacent to maxillary lateral incisors. Intra-and interobserver agreements were evaluated. Results The intra-and interobserver agreements were excellent (correlation coefficients >= 0.94). GVs in the apical region were significantly higher around impacted canines compared with erupted teeth (P = 0.003). Conversely, in the cervical region, erupted canines demonstrated higher GVs than impacted canines. Most impactions had a mesio-angular and predominantly palatal position. The prevalence of impaction was higher in females; however, no statistically significant correlation was found between the GVs and sex or type of impaction (P > 0.05). Conclusion The results showed a significant relationship between the GVs and maxillary canine impaction status, such that the GV was lower in the cervical region and higher in the apical region around impacted canines compared with erupted canines. This pattern may reflect altered bone remodeling or increased osteoblastic activity in the area and may indicate a possible effect of bone density on tooth eruption. Further studies are recommended with a larger sample size using other devices.