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Updated: May 13, 2025
Author Spotlight: 3D Movement Assessment of Maxillary Posterior Teeth in Clear Aligner Treatment
Published on: February 23, 2024
Using panoramic radiographs to assess the probability of causing oroantral communication following tooth removal. A
M M Bakacak1,2, R C Hoogeveen3, W E R Berkhout2
1Department of Oral and Maxillofacial Surgery, Diakonessenhuis, Bosboomstraat 1, Utrecht, 3582 KE, The Netherlands.
Objectives:
To preoperatively assess the probability of oroantral communication (OAC) following the removal of maxillary (pre)molars using panoramic radiographs (PAN) and to assess the OAC-rate.
Materials And Methods:
During a 4,5-year period, patient characteristics of removals of maxillary (pre-)molars were recorded: 'sex', age, 'sidedness', 'type of tooth', 'reason for removal'' and 'occurrence of OAC'. On the PAN of OAC-cases and of 100 control cases, the 'Fraction of the Root Overlapping the Maxillary Sinus' (FROMS) was calculated. The OAC-rate was reported overall, per tooth type and for four diagnostic classes: A: no overlap, B: 0.1-25%, C: 25.1-50% and D > 50% overlap. Univariate tests and regression analysis were performed to test the association between OAC-rate and 'FROMS', 'sex', age, 'sidedness', 'type of tooth', 'reason for removal'.
Results:
Of 2340 maxillary (pre-)molars removed, 112 resulted in OAC (OAC-rate of 4.8% (95%CI 3.9%-5.7%)) The FROMS diagnostic class was significantly associated with the OAC-rate (χ2 = 42.90 df3, p < 0.0001). For the four diagnostic classes the risk of OAC was (A) 1.0%, (B) 3.3%. (C) 10.1% and (D) 17.7%. The first molar showed highest OAC-rate with 7.0%. No association between OAC-rate and 'sex', age, 'sidedness', 'type of tooth', 'reason for removal' was found.
Conclusions:
FROMS is a valid indicator of OAC probability. The overall OAC-rate was 4.8% and was highest in first molar removal.
Clinical Relevance:
Dentists and oral surgeons using PAN to assess OAC probability, can anticipate possible OAC and counsel patients.
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