Matzen Louise H, Petersen Lars B, Wenzel Ann
Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
Dentomaxillofac Radiol. 2016;45(4):20150226. doi: 10.1259/dmfr.20150226. Epub 2016 Mar 4.
To assess radiographic methods and diagnostically sufficient images used before removal of mandibular third molars among randomly selected general dental clinics. Furthermore, to assess factors predisposing for an additional radiographic examination.
2 observers visited 18 randomly selected clinics in Denmark and studied patient files, including radiographs of patients who had their mandibular third molar(s) removed. The radiographic unit and type of receptor were registered. A diagnostically sufficient image was defined as the whole tooth and mandibular canal were displayed in the radiograph (yes/no). Overprojection between the tooth and mandibular canal (yes/no) and patient-reported inferior alveolar nerve sensory disturbances (yes/no) were recorded. Regression analyses tested if overprojection between the third molar and the mandibular canal and an insufficient intraoral image predisposed for additional radiographic examination(s).
1500 mandibular third molars had been removed; 1090 had intraoral, 468 had panoramic and 67 had CBCT examination. 1000 teeth were removed after an intraoral examination alone, 433 after panoramic examination and 67 after CBCT examination. 90 teeth had an additional examination after intraoral. Overprojection between the tooth and mandibular canal was a significant factor (p < 0.001, odds ratio = 3.56) for an additional examination. 63.7% of the intraoral images were sufficient and 36.3% were insufficient, with no significant difference between images performed with phosphor plates and solid-state sensors (p = 0.6). An insufficient image predisposed for an additional examination (p = 0.008, odds ratio = 1.8) but was only performed in 11% of the cases.
Most mandibular third molars were removed based on an intraoral examination although 36.3% were insufficient.
评估随机选择的普通牙科诊所中，下颌第三磨牙拔除术前使用的影像学方法及诊断充分的影像。此外，评估促使进行额外影像学检查的因素。
两名观察者走访了丹麦18家随机选择的诊所，研究患者档案，包括已拔除下颌第三磨牙患者的X光片。记录了X光设备及感受器类型。诊断充分的影像定义为X光片中显示出整颗牙齿及下颌管（是/否）。记录牙齿与下颌管之间的过度投影（是/否）以及患者报告的下牙槽神经感觉障碍（是/否）。回归分析检验第三磨牙与下颌管之间的过度投影及口内影像不充分是否会促使进行额外的影像学检查。
共拔除1500颗下颌第三磨牙；其中1090颗进行了口内检查，468颗进行了全景检查，67颗进行了CBCT检查。仅进行口内检查后拔除1000颗牙齿，全景检查后拔除433颗，CBCT检查后拔除67颗。90颗牙齿在口内检查后进行了额外检查。牙齿与下颌管之间的过度投影是进行额外检查的一个重要因素（p < 0.001，比值比 = 3.56）。63.7%的口内影像充分，36.3%不充分，使用磷光板和固态传感器拍摄的影像之间无显著差异（p = 0.6）。影像不充分会促使进行额外检查（p = 0.008，比值比 = 1.8），但仅在11%的病例中进行。
大多数下颌第三磨牙是基于口内检查拔除的，尽管36.3%的口内影像不充分。
