Priya P Vani, Nasyam Fazil A, Ramprasad M, Penumatsa Narendra V, Akifuddin Syed
Department of Dental Surgery, Sri Venkateshwara Institute of Medical Sciences, Tirupathi, AndhraPradesh, India.
Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Abdul Aziz University, Kingdom of Saudi Arabia.
J Int Soc Prev Community Dent. 2016 Dec;6(Suppl 3):S219-S225. doi: 10.4103/2231-0762.197198.
This study was conducted to compare the clinical assessment of impacted third molars of mandible with panaromic radiograph (OPG) and intraoral periapical radiograph (IOPA) and to assess the efficacy of IOPA and. Moreover, we corroborated the OPG and IOPA findings of impacted mandiblar third molar root apex to inferior alveolar canal.
A total of 200 patients with pericoronitis were examined who were indicated for surgical extraction, among which 50 patients were selected for the study. All the patients underwent a radiographic survey with a digital OPG and IOPA of impacted mandibular third molars, along with clinical survey for anatomic relationship, type of impaction, space available, position in relation to second molar, number of roots, root curvature, and proximity of nerve canal. The data was subjected to statistical analysis. The Statistical Package for Social Sciences version 4.0.1 software was used for analyzing the collected data.
The study revealed that IOPA was more accurate in determining a majority of the factors affecting the third molar surgery, including relationship of the external oblique ridge (IOPA vs OPG = 96%:90%), anteroposterior relation with ramus (IOPA vs OPG = 70%:66%), vertical depth of impaction (IOPA vs OPG = 72%:68%), number of roots ( = 0.013), morphology of roots (IOPA vs OPG = 96%:90%); however, OPG was found to be accurate in evaluating the type of impaction (IOPA vs OPG = 88%:94%), canal relation, along with root of impacted molar (IOPA vs OPG = 74%:86%).
To conclude, although IOPA has a marginal angle over OPG in assessing various parameters, only the number of roots have a greater accuracy ( < 0.0013) in IOPA than with OPG. However, the OPG is the better choice to be considered when the patient is associated with trismus.
本研究旨在比较全景X线片（OPG）和口内根尖片（IOPA）对下颌阻生第三磨牙的临床评估，并评估IOPA的有效性。此外，我们证实了OPG和IOPA在下颌阻生第三磨牙根尖至下牙槽神经管方面的检查结果。
共检查了200例因冠周炎需手术拔除的患者，从中选取50例患者进行研究。所有患者均接受了数字化OPG和IOPA对下颌阻生第三磨牙的影像学检查，以及关于解剖关系、阻生类型、可用间隙、与第二磨牙的位置关系、牙根数量、牙根弯曲度和神经管接近程度的临床检查。对数据进行统计分析。使用社会科学统计软件包4.0.1版本软件分析收集的数据。
研究表明，IOPA在确定影响第三磨牙手术的大多数因素方面更准确，包括外斜线的关系（IOPA对OPG = 96%:90%）、与下颌支的前后关系（IOPA对OPG = 70%:66%）、阻生的垂直深度（IOPA对OPG = 72%:68%）、牙根数量（P = 0.013）、牙根形态（IOPA对OPG = 96%:90%）；然而，发现OPG在评估阻生类型（IOPA对OPG = 88%:94%）、神经管关系以及阻生磨牙的牙根方面更准确（IOPA对OPG = 74%:86%）。
总之，虽然IOPA在评估各种参数方面比OPG有一定优势，但只有牙根数量在IOPA中的准确性（P < 0.0013）高于OPG。然而，当患者伴有牙关紧闭时，OPG是更好的选择。
