Preoperative evaluation of third molar root characteristics: Correlation between clinical and radiographic findings
DOI:
https://doi.org/10.15448/1980-6523.2015.4.14162Keywords:
Dental, radiography, Molar, tyhird, Impacted tooth, surgery, oralAbstract
Purpose: In this study, periapical and panoramic radiographic tests were compared to the clinical examination (after extraction, gold standard) to verify their accuracy in identifying number of roots, root morphology, and presence of root dilaceration in impacted third molars. Methods: In total, 98 third molars were extracted (50 maxillary, 48 mandibular). Three dental surgeons and one radiologist were calibrated to analyze the root characteristics before (radiography) and after extraction. Agreement between clinical and radiographic findings was analyzed with weighted kappa (κ) statistics. Correlation between radiographic and clinical data was assessed using Spearman correlation test. A 5% significance level was set for all analyses. Results: Upper teeth with single/fused roots and lower teeth with two roots were predominant. Higher agreement and correlation for number of roots and root morphology was observed for periapical (κ=0.258–0.612; R2=0.463–0.612; P<0.001) compared with panoramic exam (κ=0.164–0.365; R2=0.175–0.417; P<0.01), and for lower compared with upper teeth. For lower teeth, convergent/parallel roots were predominant in the clinical analysis, while divergent roots were predominant in the imaging tests. For root dilaceration, poor agreement (κ=0.199–0.273) and low correlation (R2=0.185–0.306) was observed for either radiographic examinations. Conclusion: The accuracy of radiographic examinations in identifying the root characteristics of impacted third molars was generally low. Compared with the panoramic test, periapical radiography had better agreement and higher correlation with the clinical findings for all root features.References
Hashemipour MA, Tahmasbi-Arashlow M, Fahimi-Hanzai F. Incidence of impacted mandibiular and maxillary third molars: a radiographic study in a Southeast Iran population. Med Oral Patol Oral Cir Bucal. 2013 Jan; 18(1):e140-5.
Kim TW, Artun J, Behbehani F, Artese F. Prevalence of third molar impaction in orthodontic patients treated non extraction and with extraction of 4 premolars. Am J Orthod Dentofacial Orthop. 2003 Feb;123(2):138-45.
Sandhu S, Kaur T. Radiographic study of the positional changes and eruption of impacted third molars in young adults of an Asian Indian population. J Oral Maxillofac Surg. 2008 Aug;66(8):1617-24.
Pell GJ, Gregory GT. Report on a ten-year study of a tooth division technique for the removal of impacted teeth. Am J Orthod Oral Surg. 1942 Nov; 28(11):B660-6.
Westesson PL, Carlsson LE. Anatomy of mandibular third molars. A comparison between radiographic appearance and clinical observations. Oral Surg Oral Med Oral Pathol. 1980 Jan;49(1):90-4.
Grau-Manclus V, Gargallo-Albiol J, Almendros-Marques N, Gay-Escoda C. Mandibular fractures related to the surgical extraction of impacted lower third molars: a report of 11 cases. J Oral Maxillofac Surg. 2011 May;69(5):1286-90.
Atieh MA. Diagnostic accuracy of panoramic radiography in determining relationship between inferior alveolar nerve and mandibular third molar. J Oral Maxillofac Surg. 2010 Jan;68(1):74-82.
Bell GW, Rodgers JM, Grime RJ, Edwards KL, Hahn MR, Dorman ML, et al. The accuracy of dental panoramic tomographs in determining the root morphology of mandibular third molar teeth before surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Jan;95(1):119-25.
Ríos-Santos JV, Ridao-Sacie C, Bullón P, Fernández-Palacín A, Segura- Egea JJ. Periapical status: a comparative study using film-based periapical radiographs and digital panoramic images. Med Oral Patol Oral Cir Bucal. 2010 Nov 1;15(6):e952-6.
Chandler LP, Laskin DM. Accuracy of radiographs in classification of impacted third molar teeth. J Oral Maxillofac Surg. 1988 Aug;46(8):656-60.
Akadiri OA, Obiechina AE, Arotiba JT, Fasola AO. Relative impact of patient characteristics and radiographic variables on the difficulty of removing impacted mandibular third molars. J Contemp Dent Pract. 2008 May 1;9(4):51-8.
Chen SK, Huang GF, Cheng SJ. The relationship between radiologic interpretation and root tip fracture during tooth extraction performed by junior clinicians. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Oct;92(4):470-2.
Pawelzik J, Cohnen M, Willers R, Becker J. A comparison of conventional panoramic radiographs with volumetric computed tomography images in the preoperative assessment of impacted mandibular third molars. J Oral Maxillofac Surg. 2002 Sept;60(9):979-84.
Downloads
Published
Issue
Section
License
COPYRIGHT
The submission of originals to Odonto Ciência implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Odonto Ciência as the site of original publication.
CREATIVE COMMONS LICENSE
As this journal is open access, the articles are allowed free use in scientific and educational applications, with citation of the source.
According to the type of Creative Commons License (CC-BY 4.0) adopted by Odonto Ciência, the user must respect the requirements below.
You are free to:
Share — copy and redistribute the material in any medium or format.
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
However, only under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests Odonto Ciência endorses you or your use.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
For more details on the Creative Commons license, please follow the link in the footer of this website.