Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;52(7):20230128.
doi: 10.1259/dmfr.20230128. Epub 2023 Sep 4.

Does cone beam CT change the treatment decision for maxillary second and third molars? A prospective study

Louise Hermann  1 , Sven Erik Nørholt  2   3 , Ann Wenzel  1 , Pankaj Taneja  2 , Louise Hauge Matzen  1
Affiliations

Does cone beam CT change the treatment decision for maxillary second and third molars? A prospective study

Louise Hermann et al. Dentomaxillofac Radiol. 2023 Oct.

Abstract

Objectives: To evaluate whether information from CBCT changes the treatment plan for maxillary second and third molars and to examine clinical and radiographic parameters with an impact on treatment decision.

Methods: This prospective study included 260 maxillary third molars with superimposition onto the second molar in panoramic images (170 patients; mean age 28 years, range 16-63). An initial treatment plan was based on clinical findings and panoramic images. After CBCT, a final treatment plan was decided. Treatment was undertaken based on the final treatment plan. Through logistic regression analyses, impact of clinical and radiographic parameters on change in treatment plan, removal of the third molar vs no treatment, and removal of the second vs third molar were evaluated.

Results: The treatment plan changed in 82 cases (32%). Sixteen cases (6%) changed from removal of the third molar to removal of the second molar. Regression analyses showed that severe resorption in the second molar was significantly related to a change in treatment plan. Removal of a third molar was decided in 180 cases and regression analyses identified that mesioangulation of the third molar, marginal bone loss, superficial resorption, and age were significantly related to removal of the third molar vs no treatment. Thirty second molars were removed, and regression analyses showed that severe resorption was significantly related to removal of the second molar instead of the third molar.

Conclusions: Parameters such as resorption evaluated in CBCT can modify the treatment decision, resulting in removal of the second and/or the third molar.

Keywords: Cone Beam Computed Tomography; Diagnostic Imaging; Maxilla; Panoramic Radiography; Third Molar.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Flowchart demonstrating the initial treatment plan based on a panoramic image and the final treatment plan based on CBCT for the 260 cases. *changes in treatment plan. M2, maxillary second molar; M3, maxillary third molar.
Figure 2.
Figure 2.
A right side impacted maxillary third molar shown in the panoramic image (a); CBCT image in the axial plane (b); CBCT image in the sagittal plane, ERR is marked with an arrow (c). CBCT shows ERR in the middle portion of the distobuccal root of the second molar, ERR is marked with an arrow. ERR is seen less than halfway through dentin. ERR, external root resorption.
Figure 3.
Figure 3.
A right side impacted maxillary third molar shown in the panoramic image (a); CBCT image in the axial plane (b); CBCT image in the sagittal plane, ERR is marked with an arrow (c). CBCT shows ERR in the middle portion of the distobuccal root of the second molar, ERR is marked with an arrow. ERR involves the pulp of the second molar. ERR, external root resorption.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ventä I, Vehkalahti MM, Huumonen S, Suominen AL. Signs of disease occur in the majority of third molars in an adult population. Int J Oral Maxillofac Surg 2017; 46: 1635–40. doi: 10.1016/j.ijom.2017.06.023 - DOI - PubMed
    1. Sarica I, Derindag G, Kurtuldu E, Naralan ME, Caglayan F. A retrospective study: do all impacted teeth cause pathology Niger J Clin Pract 2019; 22: 527–33. doi: 10.4103/njcp.njcp_563_18 - DOI - PubMed
    1. European Commision . European guidelines on radiation protection in dental radiology: The safe use of radiographs in dental practice . In: Radiation protection. European Commision; 2004.
    1. Matzen LH, Berkhout E. Cone beam CT imaging of the Mandibular third molar: A position paper prepared by the European Academy of Dentomaxillofacial Radiology (EADMFR). Dentomaxillofac Radiol 2019; 48(): 20190039. doi: 10.1259/dmfr.20190039 - DOI - PMC - PubMed
    1. Moreira-Souza L, Butini Oliveira L, Gaêta-Araujo H, Almeida-Marques M, Asprino L, Oenning AC. Comparison of Cbct and panoramic radiography for the assessment of bone loss and root Resorption on the second molar associated with third molar Impaction: A systematic review. Dentomaxillofac Radiol 2022; 51(): 20210217. doi: 10.1259/dmfr.20210217 - DOI - PMC - PubMed