Radiographic pathways for ectopic and impacted teeth: A survey of British Orthodontic Society and British Association of Oral Surgeons members

Title: Radiographic pathways for ectopic and impacted teeth: A survey of British Orthodontic Society and British Association of Oral Surgeons members

Abstract:

Objective: This study aimed to assess radiographic practices for ectopic and impacted teeth among orthodontists and oral surgeons (OS) that are members of the British Orthodontic Society and British Association of Oral Surgeons, and to evaluate adherence to current guidelines in light of emerging low-dose Cone Beam Computed Tomography (CBCT) technology.
Materials and Methods: A 17-item questionnaire was distributed via mailing lists to members of the British Orthodontic Society (n=1842) and British Association of Oral Surgeons (n=1057). Descriptive statistics were used to summarise the sample characteristics and questionnaire responses.
Results: A total of 355 responses were received, an overall response rate of 12%: 195 orthodontists (response rate 11%) and 160 OS (response rate 15%). Forty percent of orthodontists and thirty percent of OS routinely obtained 2 plain film radiographs as first-line assessment. However, most clinicians (72% orthodontists; 79% OS) reported bypassing additional parallax radiographs when they anticipated requiring a CBCT. Most respondents agreed that CBCT improved diagnostic confidence, and over 80% reported having changed a diagnosis or treatment plan after CBCT imaging. Three-quarters of clinicians (75–79%) indicated that revised guidelines recommending justification of CBCT after 1 plain film radiograph would influence their practice.
Conclusion: Radiographic practice varies considerably across and within specialties, reflecting differences in clinical experience, available resources, and radiation protocols. These findings highlight the need for updated, evidence-based, cross-specialty guidelines for the radiographic assessment of ectopic and impacted teeth, considering contemporary CBCT capabilities and modern radiation-protection principles. Future guidelines should support clinician judgment, while balancing diagnostic benefit against patient radiation exposure.

Biography:

Navneet Bhamra is an Orthodontics Specialty Registrar at Guy's and St Thomas' NHS Foundation Trust and William Harvey Hospital, Ashford. She holds a BDS and BSc, and is a Member of the Faculty of Dental Surgery, Royal College of Surgeons of Glasgow (MFDS RCS Glasg). Her clinical and research interests lie in orthodontics. Prior to her current post, she worked as a Dental Officer and gained broad experience as a Dental Core Trainee in Oral and Maxillofacial Surgery and Restorative Dentistry, before serving as a Clinical Fellow in Paediatric Dentistry.