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South African Dental Journal

On-line version ISSN 0375-1562
Print version ISSN 0011-8516


THOMAS, E; SETHUSA, MPS  and  SINGH, R. The use of cone beam computed tomography in establishing the etiology of an impacted tooth. S. Afr. dent. j. [online]. 2020, vol.75, n.1, pp.37-42. ISSN 0375-1562.

Cone Beam Computed Tomography (CBCT), a three-dimensional imaging modality, is considered a groundbreaking advance in the field of dental imaging. This case report illustrates how the use of CBCT enabled the correct diagnosis of the cause of the impaction of a central incisor in an orthodontic patient. A 10-year-old male patient presented with the chief complaint of a clinically missing permanent upper right central incisor. After clinical examination and history taking, diagnostic radiographs such as orthopantomo-graphs, lateral cephalograms and periapical radiographs were taken. On examination, the panoramic radiograph and lateral cephalogram demonstrated that the central incisor was impacted. The clinical signs, symptoms, and radiographic features indicated that an odontoma was causing the impaction. However, the presentation on the periapical radiographic presentation was suggestive of gemination, a developmental anomaly. A CBCT scan was requested to confirm whether there were two structures (odontoma and impacted central) or one single structure (gemination). The CBCT scans helped in determining the correct etiology for the clinically missing central incisor and aided the clinician to arrive at the definitive diagnosis that a supernumerary tooth was responsible for the impaction. The scan also helped in identifying the optimal path for surgical removal of the supernumerary tooth.

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