The reliability of dental panoramic tomographs in determining the upper and lower third molar root morphology

Bojan Gačić; Branislav Ilić; Jovana Bakalović; Marija Mitrović; Jovana Kuzmanović Pficer; Bojan Jovičić; Bojan Janjić

doi:10.2298/VSP230302029G

Bojan Gačić University of Belgrade, Faculty of Dental Medicine, Clinic for Oral Surgery, Belgrade, Serbia
Branislav Ilić
Jovana Bakalović University of Belgrade, Faculty of Dental Medicine, Belgrade, Serbia
Marija Mitrović University of Belgrade, Faculty of Dental Medicine, Belgrade, Serbia
Jovana Kuzmanović Pficer University of Belgrade, Faculty of Dental Medicine, Department of Medical Statistics and Informatics, Belgrade, Serbia
Bojan Jovičić Military Medical Academy, Dental Clinic, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Bojan Janjić University of Belgrade, Faculty of Dental Medicine, Clinic for Oral Surgery, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP230302029G

Ključne reči: procena, istraživanja, umnjaci, ortopantomografija, zub, koren

Sažetak

Uvod/Cilj. Nedostaci ortopantomografske (OPT) metode, kao i neadekvatne interpretacije radiografskih snimaka mogu imati za posledicu pogrešno planiranje i komplikacije koje nastaju tokom ili nakon ekstrakcije umnjaka. Cilj rada bio je da se utvrdi validnost i pouzdanost OPT nalaza u proceni morfologije korenova umnjaka nakon ekstrakcije, kao i to da li stepen kliničkog iskustva utiče na preciznost procene. Metode. Studija preseka sprovedena je na 200 pacijenata kojima je bila indikovana ekstrakcija umnjaka. Preoperativna OPT procena sprovedena je od strane ispitivača koji su na osnovu nivoa iskustva bili svrstani u tri grupe: studente, specijalizante i profesore. Nakon ekstrakcije umnjaka beležena je morfologija njihovih korena, a preciznost procene izvršena je primenom različitih statističkih testova. Rezultati. Najviši procenat uspešnih procena utvrđen je za jednokorene gornje i donje umnjake. Postojala je statistički značajna razlika u pogledu uspešnosti procene profesora u odnosu na procenu studenata i specijalizanata (p = 0,0015). Vrednosti weighted Cohen’s kappa (k_w) su se postepeno uvećavale idući od grupe studenata ka grupi profesora (0,06, 0,28, 0,34, redom). Najveće razmimoilaženje odgovora postojalo je kada su se poredile grupa studenti i grupa profesori (slabo, k_w = 0,25584). Zaključak. U ovoj studiji nisu pokazani rezultati koji potvrđuju pouzdanost OPT snimka za procenu tačne morfologije korena trećih molara. Nivo kliničkog iskustva utiče na uspešnost procene, ali kompleksnije kliničke slučajeve trebalo bi procenjivati različitim dijagnostičkim metodama.

Reference

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; 95(1): 119‒25.

Ali S, Geelani R, Shah SAA. Assessment of diagnostic accuracy of orthopantomogram in determining the root morphology of impacted mandibular third molars. Pak Oral Dent J 2015; 35(3): 390‒4.

Vishal, Khaitan T, Ranjan R, Sharma N. Primary closure after surgical extraction of mandibular third molar with or without tube drain: A prospective study. J Family Med Prim Care 2020; 9(2): 637‒41.

Duarte-Rodrigues L, Miranda EFP, Souza TO, de Paiva HN, Falci SGM, Galvão EL. Third molar removal and its impact on quality of life: systematic review and meta-analysis. Qual Life Res 2018; 27(10): 2477‒89.

Cederhag J, Truedsson A, Alstergren P, Shi XQ, Hellén-Halme K. Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden. Clin Oral Investig 2022; 26(2): 2073‒83.

Cederhag J, Lundegren N, Alstergren P, Shi XQ, Hellén-Halme K. Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population. Eur J Dent 2021; 15(2): 266‒72.

Kim YS, Park YM, Cosola S, Riad A, Giammarinaro E, Covani U, et al. Retrospective analysis on inferior third molar position by means of orthopantomography or CBCT: Periapical band-like radiolucent sign. Appl Sci 2021; 11(14): 6389.

Saraswati FK, Balajirao B, Mamatha GP. Clinical and orthopantomographic evaluation of mandibular third molar. Contemp Clin Dent 2010; 1(1): 27‒30.

Zhang W, Tang Y, Liu C, Shen Y, Feng X, Gu Y. Root and root canal variations of the human maxillary and mandibular third molars in a Chinese population: A micro-computed tomographic study. Arch Oral Biol 2018; 95: 134‒40.

Tomaszewska IM, Skinningsrud B, Jarzębska A, Pękala JR, Tarasiuk J, Iwanaga J. Internal and external morphology of mandibular molars: An original micro-CT study and meta-analysis with review of implications for endodontic therapy. Clin Anat 2018; 31(6): 797‒811.

Vesala T, Ekholm M, Ventä I. Is dental panoramic tomography appropriate for all young adults because of third molars? Acta Odontol Scand 2021; 79(1): 52‒8.

Shivpuri A, Mitra R, Hema R. A Retrospective Analysis of the Root Morphology of Maxillary and Mandibular Third Molars. Acta Sci Dent Sci 2018; 2(5): 32‒4.

D’Costa ZV, Ahmed J, Ongole R, Shenoy N, Denny C, Binnal A. Impacted Third Molars and Its Propensity to stimulate External Root Resorption in Second Molars: Comparison of Orthopantomogram and Cone Beam Computed Tomography. World J Dent 2017; 8(4): 281‒7.

Sarica I, Derindag G, Kurtuldu E, Naralan ME, Çağlayan F. A retrospective study: Do all impacted teeth cause pathology? Niger J Clin Pract 2019; 22(4): 527‒33.

Richter J, Scheiter K, Eder TF, Huettig F, Keutel C. How massed practice improves visual expertise in reading panoramic radiographs in dental students: An eye tracking study. PLoS One 2020; 15(12): e0243060.

Djordjević A, Todić J, Arsić Z, Ilić A, Jovanović R, Vlahović Z. Predictive value of the specific radiographic signs at panoramic radiography indicating possible close relationship of posterior teeth and surrounding anatomical structures: A CBCT study. Vojnosanit Pregl 2021; 78(11): 1133‒9.

Różyło-Kalinowska I. Panoramic radiography in dentistry. Clin Dent Rev 2021; 5(1): 26.

Demirtas N, Mihmanli A, Aytuğar E, Bayer S. Limitations of Panoramic Radiographs: Report of Two Cases. Bezmialem Sci 2014; 2: 82‒5.

Suomalainen A, Ventä I, Mattila M, Turtola L, Vehmas T, Peltola JS. Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(2): 276‒84.

Eder TF, Richter J, Scheiter K, Keutel C, Castner N, Kasneci E, et al. How to support dental students in reading radiographs: effects of a gaze-based compare-and-contrast intervention. Adv Health Sci Educ Theory Pract 2021; 26(1): 159‒81. Erratum in: Adv Health Sci Educ Theory Pract 2021; 26(3): 1185‒6.

GraphPad. Randomly assign subjects to treatment groups [In-ternet]. Dotmatics; 2023 [accessed on 2023 Sep 20]. Available from: http://www.graphpad.com/quickcalcs/randomize1.cfm

Pouzdanost ortopantomograma u proceni morfologije korenova gornjih i donjih umnjaka

Sažetak

Reference