DOI QR코드

DOI QR Code

Impacted mandibular third molars: a comparison of orthopantomography and cone-beam computed tomography imaging in predicting surgical difficulty

  • Husni Mubarak (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University) ;
  • Andi Tajrin (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University) ;
  • Mohammad Gazali (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University) ;
  • Nurwahida (Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University) ;
  • Fadhlil Ulum A. Rahman (Dental Hospital of Hasanuddin University)
  • 투고 : 2024.05.29
  • 심사 : 2024.10.11
  • 발행 : 2024.10.20

초록

Background: This study investigated the predictive value of orthopantomography (OPG) for the difficulty of extracting impacted mandibular third molars, in comparison with cone-beam computed tomography (CBCT). Methods: In this descriptive quantitative investigation, two oral and maxillofacial radiologists evaluated OPG and three-dimensional CBCT images according to the Pell-Gregory and Winter classifications. The results for the classification were compared using the chi-square test, and the prediction of difficulty was assessed using the Pederson scale, with a significance level of p< 0.05. Results: The study included 30 patients (14 men and 16 women), providing a total of 53 samples of impacted mandibular third molars. Of these, 30 (56.6%) were from the right side and 23 (43.4%) from the left. There was a statistically significant difference between the OPG and CBCT images concerning their relation to the mandibular ramus (p< 0.05). However, evaluations based on occlusal lines and angulation showed no significant differences (p> 0.05). According to the Pederson scale, significant differences were observed between OPG and CBCT in predicting extraction difficulty (p< 0.05). Conclusion: CBCT offered a more accurate assessment of the surgical difficulty associated with mandibular third molars than OPG. OPG views frequently failed to adequately visualize the region of the mandibular ramus, influencing the perceived difficulty of mandibular third molar surgery. In certain cases, the use of CBCT imaging is crucial.

키워드

참고문헌

  1. Chauhan V, Wilkins RC. A comprehensive review of the literature on the biological effects from dental X-ray exposures. Int J Radiat Biol 2019;95:107-19. 
  2. White SC, Pharoah MJ. Oral radiology: principle and interpretation. Vol 4. Elsevier; 2014. 
  3. Talib Jiboon A, Alhamdani FY, Hussein Ali N. Radiographic examination before dental extraction from dentists' perspective. Int J Dent 2023;2023:4970981. 
  4. Mark AM. Dental x-rays. J Am Dent Assoc 2019;150:636. 
  5. Matzen LH, Villefrance JS, Norholt SE, Bak J, Wenzel A. Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy: a 3-year audit. Dentomaxillofac Radiol 2020;49:20190250. 
  6. Peker I, Sarikir C, Alkurt MT, Zor ZF. Panoramic radiography and cone-beam computed tomography findings in preoperative examination of impacted mandibular third molars. BMC Oral Health 2014;14:71. 
  7. Brasil DM, Nascimento EH, Gaeta-Araujo H, Oliveira-Santos C, Maria de Almeida S. Is panoramic imaging equivalent to cone-beam computed tomography for classifying impacted lower third molars? J Oral Maxillofac Surg 2019;77:1968-74. 
  8. Jaron A, Gabrysz-Trybek E, Bladowska J, Trybek G. Correlation of panoramic radiography, cone-beam computed tomography, and three-dimensional printing in the assessment of the spatial location of impacted mandibular third molars. J Clin Med 2021;10:4189. 
  9. Venkatesh E, Elluru SV. Cone beam computed tomography: basics and applications in dentistry. J Istanb Univ Fac Dent 2017;51:S102-21. 
  10. Kau CH, Abramivitch K, Kamel SG, Bozic M. Cone beam CT of the head and neck an anatomical atlas. Springer; 2011. 
  11. Erdelyi RA, Duma VF, Sinescu C, Dobre GM, Bradu A, Podoleanu A. Dental diagnosis and treatment assessments: between x-rays radiography and optical coherence tomography. Materials (Basel) 2020;13:4825. 
  12. Van Assche N, Vercruyssen M, Coucke W, Teughels W, Jacobs R, Quirynen M. Accuracy of computer-aided implant placement. Clin Oral Implants Res 2012;23 Suppl 6:112-23. 
  13. Diniz-Freitas M, Lago-Mendez L, Gude-Sampedro F, Somoza-Martin JM, Gandara-Rey JM, Garcia-Garcia A. Pederson scale fails to predict how difficult it will be to extract lower third molars. Br J Oral Maxillofac Surg 2007;45:23-6. 
  14. Sainz de Baranda B, Silvestre FJ, Silvestre-Rangil J. Relationship between surgical difficulty of third molar extraction under local anesthesia and the postoperative evolution of clinical and blood parameters. J Oral Maxillofac Surg 2019;77:1337-45. 
  15. Gumrukcu Z, Balaban E, Karabag M. Is there a relationship between third-molar impaction types and the dimensional/angular measurement values of posterior mandible according to Pell & Gregory/Winter Classification? Oral Radiol 2021;37:29-35. 
  16. Crecelius C. Soft tissue trauma. Atlas Oral Maxillofac Surg Clin North Am 2013;21:49-60. 
  17. Jaron A, Trybek G. The pattern of mandibular third molar impaction and assessment of surgery difficulty: a retrospective study of radiographs in East Baltic population. Int J Environ Res Public Health 2021;18:6016. 
  18. Osunde OD, Saheeb BD. Effect of age, sex and level of surgical difficulty on inflammatory complications after third molar surgery. J Maxillofac Oral Surg 2015;14:7-12. 
  19. Sukegawa S, Matsuyama T, Tanaka F, Hara T, Yoshii K, Yamashita K, et al. Evaluation of multi-task learning in deep learning-based positioning classification of mandibular third molars. Sci Rep 2022;12:684. 
  20. Khojastepour L, Khaghaninejad MS, Hasanshahi R, Forghani M, Ahrari F. Does the Winter or Pell and Gregory classification system indicate the apical position of impacted mandibular third molars? J Oral Maxillofac Surg 2019;77:2222. 
  21. Prajapati VK, Mitra R, Vinayak KM. Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: a clinical variant. Dent Res J (Isfahan) 2017;14:137-42. 
  22. Kharma MY, Sakka S, Aws G, Tarakji B, Nassani MZ. Reliability of Pederson scale in surgical extraction of impacted lower third molars: proposal of new scale. J Oral Dis 2014;2014:157523. 
  23. Bali A, Bali D, Sharma A, Verma G. Is Pederson index a true predictive difficulty index for impacted mandibular third molar surgery? a meta-analysis. J Maxillofac Oral Surg 2013;12:359-64. 
  24. Santos KK, Lages FS, Maciel CA, Gloria JC, Douglas-deOliveira DW. Prevalence of mandibular third molars according to the Pell & Gregory and Winter classifications. J Maxillofac Oral Surg 2022;21:627-33. 
  25. Mendonca LM, Gaeta-Araujo H, Cruvinel PB, Tosin IW, Azenha MR, Ferraz EP, et al. Can diagnostic changes caused by cone beam computed tomography alter the clinical decision in impacted lower third molar treatment plan? Dentomaxillofac Radiol 2021;50:20200412. 
  26. Freire BB, Nascimento EH, Vasconcelos KF, Freitas DQ, HaiterNeto F. Radiologic assessment of mandibular third molars: an ex vivo comparative study of panoramic radiography, extraoral bitewing radiography, and cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;128:166-75. 
  27. Devlin H, Yuan J. Object position and image magnification in dental panoramic radiography: a theoretical analysis. Dentomaxillofac Radiol 2013;42:29951683. 
  28. Tang Z, Liu X, Chen K. Comparison of digital panoramic radiography versus cone beam computerized tomography for measuring alveolar bone. Head Face Med 2017;13:2. 
  29. Dias MJ, Franco A, Junqueira JL, Fayad FT, Pereira PH, Oenning AC. Marginal bone loss in the second molar related to impacted mandibular third molars: comparison between panoramic images and cone beam computed tomography. Med Oral Patol Oral Cir Bucal 2020;25:e395-402. 
  30. Matzen LH, Wenzel A. Efficacy of CBCT for assessment of impacted mandibular third molars: a review. Based on a hierarchical model of evidence. Dentomaxillofac Radiol 2015;44:20140189. 
  31. Nasseh I, Jensen D, Noujeim M. Comparison of mesiodistal root angulation measured from conventional and CBCT derived panoramic radiographs in orthodontic patients. Open Dent J 2017;11:338-49. 
  32. Bushberg JT. Eleventh annual Warren K. Sinclair keynote address-science, radiation protection and NCRP: building on the past, looking to the future. Health Phys 2015;108:115-23.