Comparison of Radiographic and Tomographic Parameters to Determine the Accuracy and Reliability in Predicting the Difficulty of Mandibular Third Molar Extraction
Thiago Jonathan Silva dos Santos
School of Dentistry, Federal University of Ceará, Sobral Campus, Brazil.
Mateus Jorge Moreira
*
School of Dentistry, Federal University of Ceará, Sobral Campus, Brazil.
Calebe Lamonier de Oliveira Costa Paiva
School of Dentistry, Federal University of Ceará, Sobral Campus, Brazil.
Paulo Goberlanio
School of Dentistry, Dentistry at Christus University Center, Fortaleza Campus, Brazil.
Filipe Nobre Chaves
School of Dentistry, Federal University of Ceará, Sobral Campus, Brazil.
Francisco Samuel Rodrigues Carvalho
School of Dentistry, Federal University of Ceará, Sobral Campus, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Compare and correlate different radiographic and tomographic parameters in determining the degree of difficulty in the extraction of lower third molars.
Aims: To verify whether there is a statistically significant difference between predictive parameters of surgical difficulty for the removal of mandibular third molars obtained from panoramic radiographs compared to cone-beam computed tomography.
Methodology: The present study was a cross-sectional, retrospective analysis conducted through the examination of panoramic radiographs and cone-beam computed tomography scans obtained between 2018 and 2023 at the imaging sector of the undergraduate Dentistry program at the Federal University of Ceará (UFC), Sobral campus.
Results: The study revealed statistically significant differences between panoramic radiography and cone-beam computed tomography (CBCT) in the assessment of mandibular third molars, particularly regarding proximity to the inferior alveolar nerve canal, where panoramic radiographs showed high sensitivity (93.9%) but low specificity (0%). In the Pell and Gregory classification, panoramic radiographs demonstrated a sensitivity of 87.5% and a specificity of 61.1% (p = 0.004).
Conclusion: Cone-beam computed tomography is essential for a more accurate assessment of anatomy and surgical complexity, highlighting the limitations of panoramic radiographs in specific surgical planning contexts. The Pell and Gregory classification demonstrated significant differences in sensitivity and specificity between two-dimensional and three-dimensional analyses.
Keywords: Third molar, panoramic radiography, cone-beam computed tomography, pell and gregory