Comparison of dental volumetric tomography and panoramic radiography in assessing the relationship between impacted mandibular teeth and surrounding structures

Abstract

Aim: In the field of dentistry, panoramic radiography (PR) and dental volumetric tomography (DVT) play a crucial role in assessing the position of impacted teeth and their relationship with neighboring anatomical structures. The objective of this study was to investigate the association between impacted mandibular teeth and adjacent dental structures, as well as the surrounding anatomical formations, using both PR and DVT imaging techniques.

Methodology: In this retrospective study, we examined DVT and PR images of a total of 150 patients who sought treatment at Dicle University Faculty of Dentistry between 2015 and 2021. The main objective was to assess the prevalence of impacted teeth, specifically in the mandible region, and to analyze their location, as well as their association with neighboring teeth and surrounding anatomical structures, utilizing both PR and DVT imaging modalities. The collected data were analyzed using the licensed IBM SPSS 21 software package.

Results: The study included a total of 150 patients, comprising 70 women and 80 men, in whom 206 impacted teeth were detected in the radiographs. Among these, the most common classifications were impacted lower-third molars (ILTM), with a vertical orientation accounting for 41.04%, class B with a rate of 50.87%, and class II with 68.79% prevalence. The inferior alveolar canal (IAC) was found to be positioned inferiorly in 71.68% of cases, with no bone septum observed between the IAC and ILTM root in 50.87% of cases. In 23.7% of cases, the ILTM root was in contact with the lingual cortical bone, while lingual bone perforation was observed in 8.67% of cases. Significant statistical differences were found between the DVT and PR images concerning the position of the IAC and its relationship with the lingual bone, as well as the examination of distal caries and external root resorption (ERR) in the second molar tooth (p<0.05). Additionally, impacted canines were predominantly observed in the buccal position, six out of 14 teeth being in contact with the incisive canal. Positioned lingually, impacted premolars and supernumerary premolars were frequently observed. Second molars were commonly seen to be mesially inclined and not in contact with the IAC.

Conclusion: The alignment and positioning of teeth within the mandible are intricately linked to the nearby anatomical structures. It is crucial to regularly monitor impacted teeth using PR, and, in cases where there is a higher risk, it is recommended to augment the diagnosis with three-dimensional DVTs.