Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal

Shahidi, Shoaleh; Zamiri, Bardia; Bronoosh, Pegah

doi:10.5624/isd.2013.43.2.105

Cited by 35 publications

(33 citation statements)

References 15 publications

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“…Although panoramic images cannot provide three-dimensional information, numerous clinical studies [ 2 , 5 , 7 , 11 -13, 17 ] have been performed to determine panoramic findings suggestive of inferior alveolar nerve exposure or postoperative dysesthesia. In addition, many studies reported the panoramic findings that associated direct contact between inferior alveolar nerve and impacted third molar on computed tomography or cone-beam CT images [ 8 , 14 , 18 ]. In the present study, the most frequent panoramic radiographic finding was interruption of mandibular canal (69.14%), in conformity with previously published studies [ 2 - 4 , 6 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Panoramic Radiograph in Assessment of the Relationship Between Mandibular Canal and Impacted Third Molars

Tantanapornkul¹,

Mavin²,

Prapaiphittayakun³

et al. 2016

TODENTJ

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Background:The relationship between impacted mandibular third molar and mandibular canal is important for removal of this tooth. Panoramic radiography is one of the commonly used diagnostic tools for evaluating the relationship of these two structures.Objectives:To evaluate the accuracy of panoramic radiographic findings in predicting direct contact between mandibular canal and impacted third molars on 3D digital images, and to define panoramic criterion in predicting direct contact between the two structures.Methods:Two observers examined panoramic radiographs of 178 patients (256 impacted mandibular third molars). Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root, diversion of mandibular canal and narrowing of third molar root were evaluated for 3D digital radiography. Direct contact between mandibular canal and impacted third molars on 3D digital images was then correlated with panoramic findings. Panoramic criterion was also defined in predicting direct contact between the two structures.Results:Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root were statistically significantly correlated with direct contact between mandibular canal and impacted third molars on 3D digital images (p < 0.005), and were defined as panoramic criteria in predicting direct contact between the two structures.Conclusion:Interruption of mandibular canal wall, isolated or with darkening of third molar root observed on panoramic radiographs were effective in predicting direct contact between mandibular canal and impacted third molars on 3D digital images. Panoramic radiography is one of the efficient diagnostic tools for pre-operative assessment of impacted mandibular third molars.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Panoramic Radiograph in Assessment of the Relationship Between Mandibular Canal and Impacted Third Molars

Tantanapornkul¹,

Mavin²,

Prapaiphittayakun³

et al. 2016

TODENTJ

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“…In oral and maxillofacial surgery practice, OPG is the most widely used technique for evaluating the lower third molar position and its relationship with the IAN canal 6 . Several clinical studies have determined specific radiographic signs, such as darkening of the root, narrowing or diversion of the IAN canal and interruption of the superior cortical line of the IAN canal wall, being highly suggestive of the close proximity between the lower third molars and the IAN canal 1 , 2 , 3 , 6 , 11 , 12 .…”

Section: Discussionmentioning

confidence: 99%

Validity of the vertical tube-shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal

Arora

Patil

Sodhi

2015

J Korean Assoc Oral Maxillofac Surg

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ObjectivesTo assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT).Materials and MethodsFifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated.ResultsThe sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01.ConclusionThe vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.

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“…In some studies, it was found that interruption of the radiopaque borders of the canal in PAN images predicted a direct contact between the roots of the third molar and the mandibular canal observed in CBCT 45,49-52 ( Figure 1), and in other studies, it was found that darkening of the roots in PAN images predicted a direct contact between the roots of the third molar and the mandibular canal observed in CBCT. 48,50,52,53 In one of the studies darkening of the roots was present in 5 of 43 of the PAN images, and the absence of cortication between the third molar and the mandibular canal was present in 33 of 43 of CBCT images. 48 The 5 cases were interpreted with no bony separation in the CBCT images, on the other hand, 28 cases were also determined with no bony separation in the CBCT images, and therefore, the agreement between the presence of darkening of the roots in the PAN images and the absence of bone between the tooth and the mandibular canal was only 15.2%.…”

Section: Level 2-effect On Diagnostic Accuracymentioning

confidence: 93%

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Matzen

Wenzel²

2015

Dentomaxillofacial Radiology

114

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A radiographic examination of mandibular third molars is meant to support the surgeon in establishing a treatment plan. For years panoramic (PAN) imaging has been the first choice method; however, where an overprojection is observed between the third molar and the mandibular canal and when specific signs suggest a close contact between the molar and the canal, CBCT may be indicated. The present review provides an evaluation of the efficacy of CBCT for assessment of mandibular third molars using a six-tiered hierarchical model by Fryback and Thornbury in 1991. Levels 1-3 include studies on low evidence levels mainly regarding the technical capabilities of a radiographic method and the diagnostic accuracy of the related images. Levels 4-6 include studies on a higher level of evidence and assess the diagnostic impact of a radiographic method on the treatment of the patient in addition to the outcome for the patient and society including cost calculations. Only very few high-evidence studies on the efficacy of CBCT for radiographic examination of mandibular third molars exist and, in conclusion, periapical or PAN examination is sufficient in most cases before removal of mandibular third molars. However, CBCT may be suggested when one or more signs for a close contact between the tooth and the canal are present in the two-dimensional image-if it is believed that CBCT will change the treatment or the treatment outcome for the patient. Further research on high-evidence levels is needed. Dentomaxillofacial Radiology (

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Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal

Cited by 35 publications

References 15 publications

Accuracy of Panoramic Radiograph in Assessment of the Relationship Between Mandibular Canal and Impacted Third Molars

Accuracy of Panoramic Radiograph in Assessment of the Relationship Between Mandibular Canal and Impacted Third Molars

Validity of the vertical tube-shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

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