下颌阻生智齿相关第二磨牙牙根外吸收:曲面断层片与CBCT对比研究

doi:10.13591/j.cnki.kqyx.2023.01.012

Abstract

Abstract: Objective To compare the diagnostic performance between panoramic radiography(PR)and cone beam computed tomography(CBCT)in the assessment of external root resorption(ERR)of mandibular second molars associated with impacted third molars. Methods A total number of 832 patients with 1 074 mesially and horizontally impacted mandibular third molars treated at our institution from January 2019 to December 2020 were retrospectively analyzed. Presence of ERR on the adjacent second molar was investigated with PR and CBCT. Factors affecting the diagnostic accuracy of PR were determined. Results The overall incidence of ERR in second molars was 33.15%(356/1 074)as detected by CBCT images. The accuracy of PR was 66.39%. Multivariate Logistic regression analyses further revealed that middle and Class Ⅲ impaction, crown contact or overlap with the root of adjacent tooth were risk factors for inaccurate diagnosis of PR(P<0.05). Conclusion The accuracy of detection on ERR of mandibular second molar associated with impacted third molar using panoramic radiography is lower. CBCT is recommended for this clinical scenario.

Key words: impacted mandibular third molar, mandibular second molar, external root resorption, panoramic radiography, CBCT

CLC Number:

R782.13

SONG Hongcheng, HUANG Hong, WANG Zhifan, JING Qiuping, WANG Dongmiao. Comparison of panoramic radiography and cone-beam computed tomography images for detecting external root resorption of mandibular second molar associated with third molar impaction[J]. Stomatology, 2023, 43(1): 70-74.

Figures/Tables 4

Fig.1

Fig.2

Tab.1

Tab.2

References 20

[1]	Iglesias-Linares A, Hartsfield JK Jr. Cellular and molecular pathways leading to external root resorption[J]. J Dent Res, 2017, 96(2):145-152. doi: 10.1177/0022034516677539 pmid: 27811065
[2]	Li DN, Tao YW, Cui MY, et al. External root resorption in maxillary and mandibular second molars associated with impacted third molars:A cone-beam computed tomographic study[J]. Clin Oral Investig, 2019, 23(12):4195-4203. doi: 10.1007/s00784-019-02859-3
[3]	Oenning ACC, Neves FS, Alencar PNB, et al. External root resorption of the second molar associated with third molar impaction:Comparison of panoramic radiography and cone beam computed tomography[J]. J Oral Maxillofac Surg, 2014, 72(8):1444-1455. doi: 10.1016/j.joms.2014.03.023
[4]	Oenning AC, Freire AR, Rossi AC, et al. Resorptive potential of impacted mandibular third molars:3D simulation by finite element analysis[J]. Clin Oral Investig, 2018, 22(9):3195-3203. doi: 10.1007/s00784-018-2403-4
[5]	Wang DM, He XT, Wang YL, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar:Evidence from cone beam computed tomography[J]. Clin Oral Investig, 2017, 21(4):1335-1342. doi: 10.1007/s00784-016-1888-y
[6]	Keskin Tunç S, Koc A. Evaluation of risk factors for external root resorption and dental caries of second molars associated with impacted third molars[J]. J Oral Maxillofac Surg, 2020, 78(9):1467-1477. doi: 10.1016/j.joms.2020.04.041
[7]	Oenning ACC, Melo SLS, Groppo FC, et al. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars:A cone-beam computed tomographic evaluation[J]. J Oral Maxillofac Surg, 2015, 73(3):379-386. doi: 10.1016/j.joms.2014.10.008
[8]	Nemcovsky CE, Libfeld H, Zubery Y. Effect of non-erupted 3rd molars on distal roots and supporting structures of approximal teeth. A radiographic survey of 202 cases[J]. J Clin Periodontol, 1996, 23(9):810-815. doi: 10.1111/j.1600-051x.1996.tb00616.x pmid: 8891930
[9]	Brasil DM, Nascimento EHL, Gaêta-Araujo H, et al. Is panoramic imaging equivalent to cone-beam computed tomography for classifying impacted lower third molars?[J]. J Oral Maxillofac Surg, 2019, 77(10):1968-1974. doi: 10.1016/j.joms.2019.03.041
[10]	Al-Khateeb TH, Bataineh AB. Pathology associated with impacted mandibular third molars in a group of Jordanians[J]. J Oral Maxillofac Surg, 2006, 64(11):1598-1602. doi: 10.1016/j.joms.2005.11.102
[11]	Ericson S, Kurol J. Incisor root resorptions due to ectopic maxillary canines imaged by computerized tomography:A comparative study in extracted teeth[J]. Angle Orthod, 2000, 70(4):276-283. doi: 10.1043/0003-3219(2000)070<0276:IRRDTE>2.0.CO;2 pmid: 10961776
[12]	Araujo G, Peralta-Mamani M, Silva A, et al. Influence of cone beam computed tomography versus panoramic radiography on the surgical technique of third molar removal:A systematic review[J]. Int J Oral Maxillofac Surg, 2019, 48(10):1340-1347. doi: 10.1016/j.ijom.2019.04.003
[13]	Reia VCB, de Toledo Telles-Araujo G, Peralta-Mamani M, et al. Diagnostic accuracy of CBCT compared to panoramic radiography in predicting IAN exposure:A systematic review and meta-analysis[J]. Clin Oral Investig, 2021, 25(8):4721-4733. doi: 10.1007/s00784-021-03942-4
[14]	Matzen LH, Berkhout E. Cone beam CT imaging of the mandibular third molar:A position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR)[J]. Dentomaxillofac Radiol, 2019, 48(5):20190039. doi: 10.1259/dmfr.20190039
[15]	Suter VGA, Rivola M, Schriber M, et al. Risk factors for root resorption of second molars associated with impacted mandibular third molars[J]. Int J Oral Maxillofac Surg, 2019, 48(6):801-809. doi: 10.1016/j.ijom.2018.11.005
[16]	Tassoker M. What are the risk factors for external root resorption of second molars associated with impacted third molars? A cone-beam computed tomography study[J]. J Oral Maxillofac Surg, 2019, 77(1):11-17. doi: 10.1016/j.joms.2018.08.023
[17]	Moreira-Souza L, Butini Oliveira L, Gaêta-Araujo H, et al. Comparison of CBCT and panoramic radiography for the assessment of bone loss and root resorption on the second molar associated with third molar impaction:A systematic review[J]. Dentomaxillofac Radiol, 2022, 51(3):20210217. doi: 10.1259/dmfr.20210217
[18]	Mendonça LM, Gaêta-Araujo H, Cruvinel PB, et al. Can diagnostic changes caused by cone beam computed tomography alter the clinical decision in impacted lower third molar treatment plan?[J]. Dentomaxillofac Radiol, 2021, 50(4):20200412. doi: 10.1259/dmfr.20200412
[19]	Matzen LH, Schropp L, Spin-Neto R, et al. Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT[J]. Dentomaxillofac Radiol, 2017, 46(1):20160330. doi: 10.1259/dmfr.20160330
[20]	Dias MJ, Franco A, Junqueira JL, et al. Marginal bone loss in the second molar related to impacted mandibular third molars:Comparison between panoramic images and cone beam computed tomography[J]. Med Oral Patol Oral Cir Bucal, 2020, 25(3):e395-e402.

检查手段		CBCT		合计
检查手段		ERR (+)	ERR(-)	合计
曲面断层片	ERR(+)	189(49.35%)	194(50.65%)	383
	ERR(-)	167(24.17%)	524(75.83%)	691
合计		356	718	1 074

诊断相关因素	曲面断层片诊断ERR		P	OR (95% CI)
诊断相关因素	正确	错误	P	OR (95% CI)
年龄/岁
18~25	193(63.49%)	111(36.51%)
26~35	265(67.95%)	125(32.05%)	0.081	0.74 (0.53, 1.04)
36~45	176(65.19%)	94 (34.81%)	0.992	1.00 (0.68, 1.47)
46~51	79 (71.82%)	31 (28.18%)	0.299	0.75 (0.44, 1.29)
性别
男	354(68.21%)	165(31.79%)
女	359(64.68%)	196(35.32%)	0.427	1.12(0.84, 1.48)
Pell和Gregory分类1
高位	178(77.39%)	52 (22.61%)
中位	374(64.59%)	205(35.41%)	0.003	1.77(1.21, 2.60)
低位	161(60.75%)	104(39.25%)	0.001	2.10(1.35, 3.25)
Pell和Gregory分类2
Ⅰ类	123(76.88%)	37 (23.12%)
Ⅱ类	409(66.50%)	206(33.50%)	0.136	1.39(0.90, 2.14)
Ⅲ类	181(60.54%)	118(39.46%)	0.018	1.77(1.10, 2.84)
下颌智齿与第二磨牙重叠
无	292(84.64%)	53 (15.36%)
颊侧	202(56.11%)	158(43.89%)	<0.001	3.21(2.19, 4.72)
中间	133(54.07%)	113(45.93%)	<0.001	4.23(2.79, 6.42)
舌侧	86 (69.92%)	37 (30.08%)	0.010	1.94(1.17, 3.21)
下颌智齿与第二磨牙接触
否	159(81.12%)	37 (18.88%)
是	554(63.10%)	324(36.90%)	0.018	1.68(1.09, 2.59)

Comparison of panoramic radiography and cone-beam computed tomography images for detecting external root resorption of mandibular second molar associated with third molar impaction

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 20

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	. Analysis of upper airway symmetry between patients with non-syndromic cleft lip and palate and skeletal Class Ⅰ [J]. , 2022, 42(7): 617-621.
[2]	. A cone-beam computed tomography study on the anatomical position of mandibular accessory foramen for adults in Sichuan [J]. , 2022, 42(2): 130-135.
[3]	. CBCT assisted evaluation of distance from cementoenamel junction to alveolar crest in Class I extraction cases [J]. , 2022, 42(11): 1011-1014.
[4]	. A preliminary study on the common indexes of the CBCT 3D cephalometric analysis [J]. , 2021, 41(8): 720-723.
[5]	. The changes of the upper airway and hyoid position following the treatment of MRC appliance in the mixed dentition with mouth breathing via Cone-beam computed tomography [J]. , 2021, 41(6): 532-536.
[6]	. Evaluation of the effect of corticotomy combined with bone augmentation surgery in the mandibular anterior teeth on labial bone augmentation [J]. , 2021, 41(6): 499-502.
[7]	Jun-Jie YE. CBCT analysis of bone characteristics of mandibular retromolar trigone and anterior ramus region in adult with different sagittal skeletal patterns [J]. , 2021, 41(6): 509-513.
[8]	. Alveolar bone in upper and lower incisor’s region of patients with different vertical facial types of skeletal Ⅲ malocclusion [J]. , 2021, 41(5): 424-429.
[9]	. A comparative study of basal and dental arch width in skeletal class III malocclusion and normal occlusion [J]. , 2021, 41(4): 309-311.
[10]	. A study on the mandibular condyle bone density. [J]. , 2021, 41(3): 222-225.
[11]	jie weizhong Jun-Jie YE Lin Wang. CBCT analysis of bone thickness of infrazygomatic crest in adults with different vertical skeletal patterns [J]. , 2021, 41(12): 1077-1080.
[12]	. The upper airway change of patients treated with Mandibular Molars Distalization by Clear Aligner [J]. , 2020, 40(6): 531-534.
[13]	Fu-Yu ZHANG. Measurement of distolingual root canal length and curvature in mandibular first molars: Three-dimensional analysis using cone-beam computed tomography [J]. , 2020, 40(6): 535-539.
[14]	. Study on correlation of alveolar bone dimension between anterior and posterior edentulous mandible by cone beam computed tomography [J]. , 2020, 40(5): 421-425.
[15]	Jie ZHANG. CBCT evaluation and analysis of midpalatal suture maturation in skeletal Class Ⅱpatients aged 10 to 20 [J]. , 2020, 40(12): 1094-1097.