Department of Oral Diagnosis - Oral Radiology Area, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Clin Oral Investig. 2023 Nov;27(11):6451-6460. doi: 10.1007/s00784-023-05249-y. Epub 2023 Sep 20.
To compare the multilayer panoramic radiography (MPAN) and conventional panoramic radiography (CPAN) in the evaluation of mandibular third molars using cone-beam computed tomography (CBCT) as a reference.
CPAN, MPAN, and CBCT scans from 33 dry human mandibles were acquired using the OP300 Maxio unit, totalizing 56 mandibular third molars to be evaluated. Three examiners evaluated each third molar according to their position, depth of impaction in the mandibular ramus, proximity between the dental root apexes and the mandibular canal, and the presence of radiographic signs of proximity to the mandibular canal. In addition, when there was a distance between the root apexes and the mandibular canal, it was measured. As a reference, these same parameters were assessed in the CBCT scans by a fourth examiner. For the statistical analysis, the weighted Kappa, Bland Altman, and Wilcoxon tests were performed (α = 0.05).
The agreement between the assessments performed in the panoramic modalities with the CBCT ranged from 66.1% to 100.0% for the categorical variables. Overall, the agreement values of CPAN and MPAN with CBCT were similar. The distances between the dental root apex and the mandibular canal for both CPAN and MPAN were significantly underestimated compared to CBCT (p < 0.05). The intra- and interexaminer agreements of the examiners ranged from poor to almost perfect; in general, the agreements were higher in the evaluation performed in the MPAN than in the CPAN.
The MPAN performs similarly to CPAN for evaluating mandibular third molars and their proximity relationship to the mandibular canal.
Preoperative evaluation of lower mandibular third molars is usually performed using CPAN. Recently, a new tool, MPAN, was developed, which has not yet been tested for the evaluation of mandibular third molars and showed similar performance to CPAN in the present study. Future studies using MPAN are encouraged to evaluate other diagnostic tasks.
通过锥形束计算机断层扫描（CBCT）作为参考，比较多层全景放射摄影术（MPAN）和传统全景放射摄影术（CPAN）在评估下颌第三磨牙中的应用。
使用 OP300 Maxio 设备获取 33 例干燥人下颌骨的 CPAN、MPAN 和 CBCT 扫描，共评估 56 颗下颌第三磨牙。3 名检查者根据下颌第三磨牙的位置、在下颌支中的阻生深度、牙根尖与下颌管的接近程度以及与下颌管接近的放射影像学征象对每颗第三磨牙进行评估。此外，当牙根尖与下颌管之间存在距离时，对其进行测量。作为参考，由第 4 名检查者在 CBCT 扫描中评估相同的参数。进行统计分析时，使用加权 Kappa、Bland Altman 和 Wilcoxon 检验（α=0.05）。
在使用全景模式进行评估时，与 CBCT 相比，分类变量的一致性为 66.1%至 100.0%。总体而言，CPAN 和 MPAN 与 CBCT 的一致性值相似。与 CBCT 相比，CPAN 和 MPAN 测量的牙根尖与下颌管之间的距离明显低估（p<0.05）。检查者的组内和组间一致性范围为差到几乎完美；总体而言，在 MPAN 评估中的一致性高于 CPAN。
MPAN 用于评估下颌第三磨牙及其与下颌管的接近关系的效果与 CPAN 相似。
下颌第三磨牙的术前评估通常使用 CPAN。最近，开发了一种新工具，即 MPAN，目前尚未对其评估下颌第三磨牙的能力进行测试，本研究表明其性能与 CPAN 相似。鼓励未来使用 MPAN 的研究评估其他诊断任务。
