External root resorption of the second molar associated with third molar impaction: comparison of panoramic radiography and cone beam computed tomography

Anne Caroline Costa Oenning, Frederico Sampaio Neves, Phillipe Nogueira Barbosa Alencar, Rodrigo Freire Prado, Francisco Carlos Groppo, Francisco Haiter-Neto
Journal of Oral and Maxillofacial Surgery 2014, 72 (8): 1444-55

PURPOSE: The aim of the present study was to compare panoramic radiography and cone beam computed tomography (CBCT) for the assessment of external root resorption (ERR) of second molars associated with impacted third molars. In addition, the prevalence of ERR in second molars and the inclinations of the third molars more associated with ERR were investigated in both imaging methods.

MATERIALS AND METHODS: The sample consisted of 66 individuals with maxillary and mandibular impacted third molars (n = 188) seen on panoramic radiographs and CBCT images. The presence of ERR on the adjacent second molar was investigated, and the position of the third molar was determined using Winter's classification (vertical, horizontal, mesioangular, distoangular, and transverse). Statistical analysis was performed using the χ(2) test, Fisher exact test, and 2-proportion Z test (the significance level was set at 5%).

RESULTS: A significantly greater number of cases of ERR (P < .0001) was diagnosed from CBCT images (n = 43, 22.88%) than panoramic radiographs (n = 10, 5.31%). The agreement between the panoramic radiographs and CBCT scans for diagnosing ERR was 4.3%. Mandibular third molars in mesioangular and horizontal inclinations were more likely to cause resorption of the adjacent teeth.

CONCLUSIONS: CBCT should be indicated for the diagnosis of ERR in second molars when direct contact between the mandibular second and third molars has been observed on panoramic radiographs, especially in mesioangular or horizontal impactions. Furthermore, considering the propensity of these teeth to cause ERR in second molars, third molar prophylactic extraction could be suggested.

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