Cone beam CT and treatment decision of mandibular third molars:: removal vs. coronectomy -a 3-year audit

Louise Hauge Matzen; Julie Suhr Villefrance; Sven Erik Nørholt; Jesper Bak; Ann Wenzel

doi:10.1259/dmfr.20190250

Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy -a 3-year audit

Department of Dentistry and Oral Health - Section for Oral Radiology and Endodontics
Department of Dentistry and Oral Health - Section for Maxillofacial Surgery and Oral Pathology

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

17 Citations (Scopus)

Abstract

OBJECTIVES: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy.

METHODS: 1437 teeth in 917 patients (mean age 27.8 years, range 18-72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision "coronectomy". Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method.

RESULTS: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. "No bony separation between the tooth and mandibular canal" seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferioralveolar nerve: one permanent and five temporary.

CONCLUSION: 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign "no bony separation between the tooth and mandibular canal" seen in CBCT.

Original language	English
Article number	20190250
Journal	Dento maxillo facial radiology
Volume	49
Issue	3
Number of pages	7
ISSN	0250-832X
DOIs	https://doi.org/10.1259/dmfr.20190250
Publication status	Published - 2020

Keywords

CBCT
clinical decision making
coronectomy
molar, third
SURGERY
INJURY
RISK
COMPUTED-TOMOGRAPHY
IMPAIRMENT
molar
EXTRACTION
third
INFERIOR ALVEOLAR NERVE
Humans
Middle Aged
Medical Audit
Tooth, Impacted
Cone-Beam Computed Tomography
Mandibular Nerve
Young Adult
Tooth Extraction
Adult
Molar, Third
Radiography, Panoramic
Mandible
Adolescent
Aged

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10.1259/dmfr.20190250

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068077/pdf/dmfr.20190250.pdf

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Cite this

@article{69aff1d7a4a4486fa10105b1dd2335a5,

title = "Cone beam CT and treatment decision of mandibular third molars:: removal vs. coronectomy -a 3-year audit",

abstract = "OBJECTIVES: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy.METHODS: 1437 teeth in 917 patients (mean age 27.8 years, range 18-72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision {"}coronectomy{"}. Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method.RESULTS: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. {"}No bony separation between the tooth and mandibular canal{"} seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferioralveolar nerve: one permanent and five temporary.CONCLUSION: 29\% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign {"}no bony separation between the tooth and mandibular canal{"} seen in CBCT.",

keywords = "CBCT, clinical decision making, coronectomy, molar, third, SURGERY, INJURY, RISK, COMPUTED-TOMOGRAPHY, IMPAIRMENT, molar, EXTRACTION, third, INFERIOR ALVEOLAR NERVE, Humans, Middle Aged, Medical Audit, Tooth, Impacted, Cone-Beam Computed Tomography, Mandibular Nerve, Young Adult, Tooth Extraction, Adult, Molar, Third, Radiography, Panoramic, Mandible, Adolescent, Aged",

author = "Matzen, \{Louise Hauge\} and Villefrance, \{Julie Suhr\} and N{\o}rholt, \{Sven Erik\} and Jesper Bak and Ann Wenzel",

year = "2020",

doi = "10.1259/dmfr.20190250",

language = "English",

volume = "49",

journal = "Dento maxillo facial radiology",

issn = "0250-832X",

publisher = "Oxford University Press",

number = "3",

}

Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy -a 3-year audit. / Matzen, Louise Hauge ; Villefrance, Julie Suhr ; Nørholt, Sven Erik et al.
In: Dento maxillo facial radiology, Vol. 49, No. 3, 20190250, 2020.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Cone beam CT and treatment decision of mandibular third molars:

T2 - removal vs. coronectomy -a 3-year audit

AU - Matzen, Louise Hauge

AU - Villefrance, Julie Suhr

AU - Nørholt, Sven Erik

AU - Bak, Jesper

AU - Wenzel, Ann

PY - 2020

Y1 - 2020

N2 - OBJECTIVES: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy.METHODS: 1437 teeth in 917 patients (mean age 27.8 years, range 18-72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision "coronectomy". Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method.RESULTS: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. "No bony separation between the tooth and mandibular canal" seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferioralveolar nerve: one permanent and five temporary.CONCLUSION: 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign "no bony separation between the tooth and mandibular canal" seen in CBCT.

AB - OBJECTIVES: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy.METHODS: 1437 teeth in 917 patients (mean age 27.8 years, range 18-72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision "coronectomy". Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method.RESULTS: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. "No bony separation between the tooth and mandibular canal" seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferioralveolar nerve: one permanent and five temporary.CONCLUSION: 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign "no bony separation between the tooth and mandibular canal" seen in CBCT.

KW - CBCT

KW - clinical decision making

KW - coronectomy

KW - molar, third

KW - SURGERY

KW - INJURY

KW - RISK

KW - COMPUTED-TOMOGRAPHY

KW - IMPAIRMENT

KW - molar

KW - EXTRACTION

KW - third

KW - INFERIOR ALVEOLAR NERVE

KW - Humans

KW - Middle Aged

KW - Medical Audit

KW - Tooth, Impacted

KW - Cone-Beam Computed Tomography

KW - Mandibular Nerve

KW - Young Adult

KW - Tooth Extraction

KW - Adult

KW - Molar, Third

KW - Radiography, Panoramic

KW - Mandible

KW - Adolescent

KW - Aged

UR - https://www.scopus.com/pages/publications/85079347296

U2 - 10.1259/dmfr.20190250

DO - 10.1259/dmfr.20190250

M3 - Journal article

C2 - 31778318

SN - 0250-832X

VL - 49

JO - Dento maxillo facial radiology

JF - Dento maxillo facial radiology

IS - 3

M1 - 20190250

ER -