Sains Malaysiana 46(1)(2017): 59–65
http://dx.doi.org/10.17576/jsm-2017-4601-08
Reliability of
Panoramic-Radiograph to Determine the Position of Third-Molar from
Inferior-Alveolar-Canal
(Kebolehpercayaan Radiograf-Panorama
untuk Menentukan Posisi Molar Ketiga dari Kanal Inferior Alveolus)
AZIZAH AHMAD FAUZI1*, MOHAMED EBRAHIM PARKER2, E.J. NORVAL2
& PHRABHAKARAN NAMBIAR3
1Department of Oral
Biology (Clinical), Faculty of Dentistry, Universiti Kebangsaan Malaysia
Jalan Raja Muda Abd Aziz,
50300 Kuala Lumpur, Federal Territory, Malaysia
2Department of Oral &
Maxillofacial Diagnostic Imaging, University of the Western Cape Robert Sobukwe
Road Bellville, 7535 Republic of South Africa
3Department of Diagnostic
& Integrated Dental Practice., University of
Malaya 50603 Kuala Lumpur, Federal Territory, Malaysia
Diserahkan: 26 Mac 2015/Diterima: 28
April 2016
ABSTRACT
Cone-beam-computed-tomography (CBCT)
has been useful in providing insights of relevant anatomy prior to surgical
procedures, including the assessment of the proximity of impacted
mandibular-third-molar to the inferior-alveolar-canal (IAC).
It is important to understand the reliability of conventional
panoramic-radiograph in the assessment of this criterion since it is more
commonly used as first line radiographic approach due to its availability and
lower radiation dose. This study aimed to investigate the reliability of
conventional panoramic-radiograph in the evaluation of the proximity of
impacted mandibular-third-molar root tip to the IAC by
correlating the results with CBCT. A total of 65 root tips
of impacted mandibular-third-molars that had both panoramic radiographs and CBCT images were included in this retrospective study. Two trained
observers participated in all image evaluations. A prepared standard 1 cm ruler
was used to measure the proximity of the third-molar root apices to the IACs.
Measurements recorded in this study were categorized into positive (root apex
above a roof of IAC), zero (root apex was superimposed
on IAC) and negative (root apex below a roof of IAC).
Data analysis was carried out using student t-test. In this study, both
observers recorded statistically significant differences in the measurement
between third-molars root apices and the IAC from panoramic radiographs
and CBCT images. The low reliability of panoramic radiograph
to assess the vertical proximity between these two anatomical structures
suggests the importance of additional assessment with CBCT in
cases where panoramic radiograph shows superimposition of the third molar root
on the roof of the canal and presence of root below the roof of the IAC.
Keywords: Panoramic radiography;
third molar
ABSTRAK
Sinaran-kon-tomografi-berkomputer
(CBCT)
amat berguna dalam memberikan kefahaman berkenaan anatomi berkaitan
sebelum prosedur pembedahan, termasuklah penilaian terhadap kedudukan
mandibular-molar-ketiga-terimpak ke kanal inferior alveolus (IAC). Adalah penting
untuk memahami kebolehpercayaan radiograf-panorama konvensional
dalam penilaian kriteria ini memandangkan ia
sering digunakan sebagai pendekatan radiografi baris hadapan kerana
lebih mudah diperoleh dan mempunyai dos radiasi yang rendah. Kajian
ini bertujuan untuk mengenal pasti kebolehpercayaan radiograf-panorama
konvensional dalam penilaian kedudukan mandibular-molar-ketiga-terimpak
ke IAC
dengan mengaitkan keputusannya dengan CBCT. Sebanyak
65 hujung akar mandibular-molar-ketiga-terimpak yang mempunyai kedua-dua
radiograf-panorama dan imej CBCT dipilih dalam kajian retrospektif
ini. Dua pemerhati terlatih terlibat
dalam penilaian keseluruhan imej. Pembaris
berpiawaian 1 cm disediakan bagi mengukur proksimiti akar molar
ke IAC.
Ukuran yang direkod dalam kajian ini dikategorikan
kepada ukuran yang bernilai positif (akar apeks di atas bumbung
IAC),
sifar (akar apeks bertindih dengan IAC) dan negatif (akar apeks di
bawah bumbung IAC). Analisis data dilakukan
dengan menggunakan ujian-t pelajar. Dalam
kajian ini, kedua-dua pemerhati merekodkan perbezaan statistik yang
signifikan dalam ukuran antara apeks akar molar-ketiga dan IAC daripada radiograf-panorama
serta imej CBCT. Kebolehpercayaan
yang rendah bagi radiograf-panorama untuk menilai proksimiti menegak
antara kedua-dua struktur anatomi ini mencadangkan kepentingan penilaian
tambahan dengan CBCT dalam kes radiograf-panorama yang menunjukkan pertindihan
akar pada bumbung molar-ketiga dan kehadiran akar di bawah bumbung
IAC.
Kata
kunci: Molar ketiga; radiograf-panorama
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*Pengarang
untuk surat-menyurat; email: azizah_fauzi@yahoo.com
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