Radiographic Features of the Gubernaculum Tract in Impacted Teeth

Introduction: The gubernaculum tract (GT) is a fibrous canal extending from the dental follicle to the alveolar crest, playing a crucial role in tooth eruption. This structure is not visible on conventional radiographs but can be reliably detected using cone-beam computed tomography (CBCT). This study aimed to evaluate the radiographic characteristics of the GT in impacted teeth using CBCT imaging. Materials and Methods: In this cross-sectional study, CBCT scans of 85 patients (41 males, 44 females) with impacted teeth, referred to Mashhad Dental School between December 2020 and December 2022, were evaluated. The mean age was 21.4 ± 11.06 years (range: 8–48 years). The presence, dimensions, morphology, and attachment patterns of the GT were assessed in coronal and sagittal planes. Data were analyzed using Chi-square and Mann-Whitney U tests (α = 0.05). Results: The GT was detectable in 36.7% of impacted teeth, with significantly higher visibility in males (P = 0.015). Canines were the most commonly affected teeth. The most frequent causes of impaction were abnormal eruption angle and tooth displacement. The GT most commonly showed central attachment in mesio-distal (64%) and bucco-lingual (76%) dimensions and occlusal attachment in the occluso-cervical direction (52%). Rectangular morphology was predominant (57%). Mean GT length and width were approximately 3.1–3.3 mm in both planes. Conclusion: CBCT enables detailed visualization of the gubernaculum tract in impacted teeth. The presence and characteristics of the GT may serve as predictive indicators for eruption disturbances and assist in treatment planning decisions.