Bastos Aline do Carmo, de Oliveira Joelma Bezerra, Mello Karina Flexa Ribeiro, Leão Patrícia Botelho, Artese Flavia, Normando David
Department of Orthodontics, Brazilian Association of Dentistry, Trav. Marques de Herval, 2298, Belém, Pará, 66.087-320, Brazil.
Department of Orthodontics, Rio de Janeiro State University, Boulevard 28 de Setembro, 157, Rio de Janeiro, RJ, CEP: 20551-030, Brazil.
Prog Orthod. 2016 Dec;17(1):21. doi: 10.1186/s40510-016-0134-0. Epub 2016 Jul 11.
The aim of this study was to evaluate the ability of oral/maxillofacial surgeons (OMFSs) and orthodontists to predict third molar eruption by examining a simple panoramic radiograph in cases where full spontaneous eruption occurred.
Panoramic radiographs of 17 patients, 13-16 years of age, were obtained just after orthodontic treatment (T1), when the third molars were intraosseous. The radiographs at T1 were presented to 28 OMFSs and 28 orthodontists-who were asked to give a prognosis for the lower third molars on both sides (n = 34). The full spontaneous eruption of all third molars was clinically observed when patients were older than 18 years (T2). These teeth were clinically asymptomatic at T1 and T2.
OMFSs decided by extractions in 49.6 % of cases while orthodontists in 37.8 % (p < 0.001), when the radiographs were examined at T1. Agreement between OMFSs and orthodontists was excellent (Kappa = 0.76, p < 0.0001), as well as intragroup agreement for both OMFSs (Kappa = 0.83) and orthodontists (Kappa = 0.96).
Despite a remarkable agreement for third molar prognosis, orthodontists and OMFSs were unable to predict lower third molar eruption by examining a simple panoramic radiograph. Both indicated extractions of a considerable number of spontaneously erupted asymptomatic teeth.
本研究的目的是通过检查全景片，评估口腔颌面外科医生（OMFSs）和正畸医生在完全自然萌出的病例中预测第三磨牙萌出的能力。
获取17例13 - 16岁患者正畸治疗刚结束时（T1）的全景片，此时第三磨牙位于骨内。将T1时的全景片呈现给28名口腔颌面外科医生和28名正畸医生，要求他们对两侧下颌第三磨牙给出预后判断（n = 34）。当患者年龄超过18岁时（T2），临床观察所有第三磨牙的完全自然萌出情况。这些牙齿在T1和T2时临床均无症状。
在T1检查全景片时，口腔颌面外科医生决定拔除的病例占49.6%，而正畸医生为37.8%（p < 0.001）。口腔颌面外科医生和正畸医生之间的一致性非常好（Kappa = 0.76，p < 0.0001），口腔颌面外科医生组内一致性（Kappa = 0.83）和正畸医生组内一致性（Kappa = 0.96）也很好。
尽管在第三磨牙预后判断上有显著一致性，但正畸医生和口腔颌面外科医生通过检查简单的全景片无法预测下颌第三磨牙的萌出。两者都建议拔除相当数量自然萌出且无症状的牙齿。
