Fahd Ali, Temerek Ahmed Talaat, Ellabban Mohamed T, Adam Samar Ahmed Nouby, Shaheen Sarah Diaa Abd El-Wahab, Refai Mervat S, Shatat Zein Abdou
Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Egyptian Russian University, Cairo, Egypt.
Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, South Valley University, Qena, Egypt.
Imaging Sci Dent. 2023 Jun;53(2):137-144. doi: 10.5624/isd.20220191. Epub 2023 Apr 15.
This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning.
Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication.
Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal.
The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.
本研究旨在评估下颌阻生第三磨牙周围的解剖结构，以展示、记录并关联常规影像学评估方案中应包含的重要发现，这些发现作为整体病例评估和治疗计划中有临床意义的因素。
根据特定纳入标准选择下颌阻生第三磨牙的锥束计算机断层扫描图像。在评估前，根据阻生牙的位置对其进行分类。对相邻的第二磨牙进行远中龋、远中骨丧失和牙根吸收的评估。第四个发现是阻生牙远中存在磨牙后管。与负责每个病例的牙医进行沟通，以确定在沟通之前他们是否检测到这些发现。
在阻生位置、远中骨丧失以及与相邻第二磨牙相关的远中龋检测之间发现了具有统计学意义的相关性。在远中骨状况评估中发现未检测到的发现比例最高，其次是磨牙后管的漏诊。
下颌阻生第三磨牙的影像学评估方案应考虑对第二磨牙进行逐步评估，临床医生应意识到水平和近中阻生中第二磨牙受影响的高发生率。由于其相关的临床考虑因素，他们还应寻找磨牙后管。
