Lucas Moreira Mendonça1, Hugo Gaêta-Araujo2, Pedro Bastos Cruvinel1, Ingrid Wenzel Tosin1, Marcelo Rodrigues Azenha3, Emanuela Prado Ferraz4, Christiano Oliveira-Santos3, Camila Tirapelli1. 1. Integrated Dental Clinic, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. 2. Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Campinas, Brazil. 3. Department of Stomatology, Public Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil. 4. Department of Oral Surgery, Prosthesis and Traumatology School of Dentistry, University of São Paulo, São Paulo, Brazil.
Abstract
OBJECTIVES: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs). METHODS: Sets of panoramic (PAN) - cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations. RESULTS: Percentage agreement and McNemar test compared PAN vs CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN vs CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with p < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images. CONCLUSIONS: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.
OBJECTIVES: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs). METHODS: Sets of panoramic (PAN) - cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations. RESULTS: Percentage agreement and McNemar test compared PAN vs CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN vs CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with p < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images. CONCLUSIONS: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.
Entities:
Keywords:
Cone beam computed tomography; Oral surgery; Radiology, and clinical decision-making; Third molar
Authors: Kate L Winstanley; Lisa M Otway; Lionel Thompson; Zoe H Brook; Nigel King; Bernard Koong; Michael O'Halloran Journal: J Investig Clin Dent Date: 2018-02-04
Authors: H Ghaeminia; G J Meijer; A Soehardi; W A Borstlap; J Mulder; S J Bergé Journal: Int J Oral Maxillofac Surg Date: 2009-07-28 Impact factor: 2.789