title: Radiographic methods used before removal of mandibular third molars among randomly selected general dental clinics.
abstract: OBJECTIVE
  To assess radiographic methods and diagnostically sufficient images used before removal of mandibular third molars among randomly selected general dental clinics. Furthermore, to assess factors predisposing for an additional radiographic examination.
  
  
  METHODS
  2 observers visited 18 randomly selected clinics in Denmark and studied patient files, including radiographs of patients who had their mandibular third molar(s) removed. The radiographic unit and type of receptor were registered. A diagnostically sufficient image was defined as the whole tooth and mandibular canal were displayed in the radiograph (yes/no). Overprojection between the tooth and mandibular canal (yes/no) and patient-reported inferior alveolar nerve sensory disturbances (yes/no) were recorded. Regression analyses tested if overprojection between the third molar and the mandibular canal and an insufficient intraoral image predisposed for additional radiographic examination(s).
  
  
  RESULTS
  1500 mandibular third molars had been removed; 1090 had intraoral, 468 had panoramic and 67 had CBCT examination. 1000 teeth were removed after an intraoral examination alone, 433 after panoramic examination and 67 after CBCT examination. 90 teeth had an additional examination after intraoral. Overprojection between the tooth and mandibular canal was a significant factor (p < 0.001, odds ratio = 3.56) for an additional examination. 63.7% of the intraoral images were sufficient and 36.3% were insufficient, with no significant difference between images performed with phosphor plates and solid-state sensors (p = 0.6). An insufficient image predisposed for an additional examination (p = 0.008, odds ratio = 1.8) but was only performed in 11% of the cases.
  
  
  CONCLUSIONS
  Most mandibular third molars were removed based on an intraoral examination although 36.3% were insufficient.
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Matzen
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Lars B
authors.initials: LB
authors.lastname: Petersen
authors.affiliation: Section of Oral Radiology, Department of Dentistry, Aarhus University, Aarhus, Denmark.
authors.forename: Ann
authors.initials: A
authors.lastname: Wenzel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data; D003718:Denmark / Q000453:epidemiology; D003740:Dental Clinics / Q000706:statistics & numerical data; D016021:Epidemiologic Studies; D005260:Female; D005792:General Practice, Dental / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging* / Q000601:surgery; D008340:Mandibular Nerve / Q000000981:diagnostic imaging; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging* / Q000601:surgery; D011856:Radiographic Image Enhancement / Q000379:methods; D016300:Radiography, Bitewing / Q000706:statistics & numerical data; D019252:Radiography, Dental, Digital / Q000706:statistics & numerical data; D011862:Radiography, Panoramic / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000706:statistics & numerical data; D061221:Trigeminal Nerve Injuries / Q000453:epidemiology; D014963:X-Ray Intensifying Screens / Q000706:statistics & numerical data; D055815:Young Adult
keywords: cone beam computed tomography; molar; radiology; third