Comparing third molar root development staging in panoramic radiography, extracted teeth, and cone beam computed...

Area of Science:

• Dentistry
• Radiology
• Forensic Odontology

Background:

• Accurate third molar development staging is crucial for various dental and forensic applications.
• Traditional methods rely on extracted teeth or panoramic radiography, each with limitations.
• Cone beam computed tomography (CBCT) offers advanced imaging but requires validation for staging accuracy.

Purpose of the Study:

• To compare the accuracy of third molar development staging across three modalities: extracted teeth (EX), panoramic radiography (PAN), and cone beam computed tomography (CBCT).
• To evaluate the applicability of a modified Gleiser and Köhler staging technique across these different assessment methods.
• To determine if PAN, the established standard, aligns with staging results from EX and CBCT.

Main Methods:

• A cohort of 158 extracted third molars from 102 patients with available PAN and CBCT scans was analyzed.
• Third molar development was staged using a modified Gleiser et al. (1955) / Köhler et al. (1994) technique.
• Polytomous logistic regression was employed to compare staging results between EX, PAN, and CBCT, with PAN serving as the reference standard.

Main Results:

• A high degree of agreement was observed, with 63.3% of pair-wise comparisons yielding identical staging results.
• In all other comparisons, the maximum difference between staging modalities was only one stage.
• No statistically significant differences (p = 0.26) were found between the staging results obtained from EX, PAN, and CBCT.
• Extracted teeth (EX) staging showed higher similarity to PAN staging (p = 0.98) compared to CBCT staging (p = 0.81 for specific stages).

Conclusions:

• The modified Gleiser and Köhler technique for third molar development staging is applicable across extracted teeth (EX), panoramic radiography (PAN), and cone beam computed tomography (CBCT).
• There are no statistically significant differences in third molar development staging among these three modalities.
• This validates the use of CBCT and extracted teeth as reliable alternatives for third molar staging, complementing traditional panoramic radiography.