Prognosis for the impacted lower third molars: Panoramic reconstruction versus tomographic images

Area of Science:

• Dentistry
• Oral Surgery
• Radiology

Background:

• Cone beam computed tomography (CBCT) is crucial for evaluating impacted mandibular third molars.
• Panoramic reconstruction (PR) and multiplanar reconstruction (MPR) are key imaging techniques for prognosis assessment.
• Understanding imaging modality impact on clinical decision-making is vital for patient care.

Purpose of the Study:

• To compare the accuracy of PR and MPR images in determining the prognosis of impacted mandibular third molars.
• To assess how these imaging techniques influence professional decision-making among dental specialists.
• To identify potential differences in treatment recommendations based on imaging interpretation.

Main Methods:

• A cross-sectional accuracy study involving 24 CBCT-derived images (10 PR, 10 MPR, plus 4 reinserted).
• 54 dental professionals (27 orthodontists, 27 oral and maxillofacial surgeons) evaluated the images.
• Statistical analysis included chi-squared, McNemar's tests, and Kappa statistics.

Main Results:

• No statistically significant differences were found between PR and MPR images for prognosis determination by either orthodontists or oral and maxillofacial surgeons.
• Significant differences emerged in professional decision-making, with oral and maxillofacial surgeons recommending more extractions than orthodontists.
• P-values indicated no significant difference for image comparison (P=.72 for orthodontists, P=.45 for OMFSs) but a significant difference for specialty decision-making (P<.0001).

Conclusions:

• PR and MPR CBCT imaging techniques are comparable for assessing the prognosis of impacted mandibular third molars.
• Specialty differences significantly influence treatment decisions, particularly regarding the necessity of extractions.
• Further research may explore the underlying reasons for specialty-specific decision-making variations.