# A Comparative Evaluation of Bone Density Surrounding Buccally and Palatally Impacted Canines Utilizing Fractal Analysis: A Retrospective Cone-Beam Computed Tomography (CBCT) Study

## TL;DR

This study found that higher bone density around palatally impacted canines may contribute to their higher occurrence compared to buccally impacted canines.

## Contribution

This is the first study to evaluate bone density as a potential factor in palatal versus buccal canine impaction using fractal analysis of CBCT scans.

## Key findings

- Palatally impacted canines had a higher mean fractal dimension (1.5563) compared to buccally impacted canines (1.3983).
- The difference in bone density between the two groups was statistically significant (p = 0.001).
- Higher bone density around palatally impacted canines suggests it is a local etiologic factor for palatal impaction.

## Abstract

Introduction: Previous studies have identified environmental and genetic causes of impaction; however, none of these studies have considered bone density as a factor. The study aimed to determine the bone density surrounding buccally and palatally impacted canines and to determine whether bone density is a contributing factor to the higher occurrence of palatal impaction.

Methods: The study sample included 20 pretreatment cone-beam computed tomography (CBCT) scans with either unilateral or bilateral impacted canines. The fractal dimension (FD) was determined using ImageJ software (National Institutes of Health, Bethesda, MD), with a focus on the interproximal region between the first and second premolars, adjacent to the impacted canine. To assess significant differences between the groups, intergroup comparisons were performed using independent samples t-tests and unpaired t-tests.

Results: The mean FD of palatally impacted canines was 1.5563, which was greater than that of buccally impacted canines (1.3983). The overall changes in FD were significant (p = 0.001).

Conclusion: Our analysis of the CBCT images revealed that bone density is higher around canines that are impacted palatally compared to those impacted buccally. Therefore, bone density is one of the local etiologic factors associated with the higher prevalence of palatal impactions.