Rubens Spin-Neto

Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

OBJECTIVES: To 1)compare pathological findings related to the mandibular third molar in panoramic images (PAN) and CBCT; 2)estimate the frequency of removals if pathological findings were indicative; and 3)assess factors in PAN associated with resorption and marginal bone loss at the second molar as observed in CBCT.

METHODS: 379 mandibular third molars were examined with PAN and CBCT. Four observers registered resorption and marginal bone loss at the second molar and increased periodontal space at the third molar in both imaging modalities. Agreement between PAN and CBCT, frequency of removals based on pathological findings in either of the two modalities, and inter-observer reproducibility was calculated. Logistic regression analyses assessed factors in PAN, which could predict marginal bone loss and resorption observed in CBCT.

RESULTS: Agreement between PAN and CBCT: resorption 54-74%; marginal bone loss 66-85%; increased periodontal space 92-97%. Removals based on CBCT 58-71% and PAN 36-65%. Inter-observer percentage accordance and kappa-values ranged from 57%-98% and 0.10-0.91, respectively for PAN and 61%-97% and 0.22-0.78, respectively for CBCT. Mesio-angulated/horizontally positioned third molars were associated with marginal bone loss (OR=7.0-31.3;P<0.001) and resorption (OR=2.9-35.6;P<0.001) in CBCT. Overprojection between the third and the second molar in PAN predicted resorption observed in CBCT (OR=5.6-21.2;P<0.001).

CONCLUSION: Pathology associated with the third molar is more often observed in CBCT than in PAN. More third molars would be removed if pathological findings are based on CBCT. Mesio-angulated/horizontally positioned third molars overprojecting the cervical/root part of the second molar in PAN are strongly associated with pathology observed in CBCT.

OriginalsprogEngelsk
Artikelnummer20160330
TidsskriftDentomaxillofacial Radiology
Vol/bind46
Nummer1
ISSN0250-832X
DOI
StatusUdgivet - jan. 2017

Se relationer på Aarhus Universitet Citationsformater

ID: 103358389