Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden

Clin Oral Investig. 2022 Feb;26(2):2073-2083. doi: 10.1007/s00784-021-04189-9. Epub 2021 Oct 1.

Abstract

Objectives: To query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences.

Materials and methods: Members of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality.

Results: The response rate was 64%. Panoramic radiographs were most commonly used in pre-surgical planning (response options: always or often), significant difference between professions (p = 0.039), and considered to facilitate treatment planning (87%), as was CBCT (82%); for 51%, CBCT reduced post-operative complications. Preferred modality for localizing the mandibular canal was fairly evenly distributed and for non-complex case, significant difference between subgroups of OMFS surgeons was found (p = 0.003) as to preference for intraoral radiographs.

Conclusions: A majority of respondents received a report within 2 weeks of their referral for CBCT and would read the report and view the images before surgery. Image modality preference differed depending on case complexity, with a greater perceived need for CBCT. Profession and practical experience affected choice.

Clinical relevance: Choice of imaging modality in mandibular third molar assessment is also important from dose delivery and social economy standpoints.

Keywords: Clinical decision-making; Dental radiography; Oral surgical procedures; Third molar; Tooth extraction.

MeSH terms

  • Cone-Beam Computed Tomography
  • Humans
  • Mandible / diagnostic imaging
  • Mandible / surgery
  • Molar, Third* / diagnostic imaging
  • Molar, Third* / surgery
  • Oral and Maxillofacial Surgeons
  • Radiography, Panoramic
  • Surveys and Questionnaires
  • Sweden
  • Tooth, Impacted* / diagnostic imaging
  • Tooth, Impacted* / surgery