Department of Oral and Maxillofacial Surgery, University of Bochum Medical School, Universitätsklinikum Knappschaftskrankenhaus Bochum, In der Schornau 23-25, D-44892, Bochum, Germany.
Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Universitätsklinikum Knappschaftskrankenhaus Bochum, In der Schornau 23-25, D-44892, Bochum, Germany.
Clin Oral Investig. 2024 Oct 9;28(11):583. doi: 10.1007/s00784-024-05964-0.
The aim of this study was to estimate the prevalence and severity of external root resorption (RR) caused by retained third molars (M3), to compare the sensitivity of panoramic radiography (PAN) and cone beam computed tomography (CBCT) and to determine predictive factors for root resorption.
In a retrospective cross-sectional analysis, we included patients (N = 367) who underwent PAN and CBCT imaging between December 2017 and July 2019. Previous orthodontic treatment, age, gender, superimposition of second molars (M2) and M3 on PAN, retention depth, inclination angle and vertical level of contact with the M2 were used as predictor variables. The outcome variable was RR of the M2, graded according to Ericson et al. [1]. Subgroup analyses compared patients with and without suspected resorption in the PAN.
While less than 5% of PANs suggested RR associated with M3, CBCT showed RR in 20% of all M2 with adjacent retained M3. The angle of inclination of M3, patient age and vertical level of molar contact emerged as predictive parameters, with mesial inclination, older age and deeper retention associated with increased severity of M2.
Within the limitations of our study, these data confirm the poor performance of PAN in the diagnosis of RR. CBCT may be helpful in detecting RR in mesioangulated and deeply retained M3 in elderly patients, even when PAN did not suggest pathology.
Our study may help to decide whether CBCT should be considered prior to M3 surgery.
本研究旨在评估因阻生第三磨牙(M3)引起的外部牙根吸收(RR)的患病率和严重程度,比较全景片(PAN)和锥形束 CT(CBCT)的敏感性,并确定 RR 的预测因素。
在回顾性横断面分析中,我们纳入了 2017 年 12 月至 2019 年 7 月间接受 PAN 和 CBCT 成像的患者(N=367)。先前的正畸治疗、年龄、性别、PAN 上第二磨牙(M2)和 M3 的重叠、保留深度、与 M2 的接触倾斜角度和垂直水平被用作预测变量。RR 是 M2 的结果变量,根据 Ericson 等人[1]进行分级。亚组分析比较了 PAN 中有无可疑 RR 的患者。
虽然不到 5%的 PAN 提示与 M3 相关的 RR,但 CBCT 在所有与相邻阻生 M3 相关的 M2 中显示出 20%的 RR。M3 的倾斜角度、患者年龄和磨牙接触的垂直水平是预测参数,近中倾斜、年龄较大和保留深度较深与 M2 的严重程度增加相关。
在本研究的限制范围内,这些数据证实了 PAN 在 RR 诊断中的性能不佳。CBCT 可能有助于在老年患者中检测到近中倾斜和深阻生 M3 的 RR,即使 PAN 未提示存在病理学。
我们的研究可能有助于决定是否应在 M3 手术前考虑 CBCT。