Objective: The aim of this study was to assess lower third molar space using four different radiographic reconstructed Cone Beam Computed Tomography (CBCT) images: orthopantomogram, lateral cephalogram, multiplanar CBCT and a newly introduced three-dimensional (3D) simulation technique.
Methods: The CBCT scans of 32 individuals (20.97 ± 2.152 years) with a total of 50 lower third molars were collected and analyzed. The ratio between the necessary space and available space for lower third molars was calculated on each radiographic reconstructed image. Repeated-measure analysis of variance followed by multiple comparison tests were used.
Results: The mean ratio was significantly smaller with cephalograms (0.611 ± 0.263), followed respectively by orthopantomograms (0.756 ± 0.221), multiplanar CBCT (0.789 ± 0.191) and 3D simulation technique (0.807 ± 0.193) (p < 0.001). The lowest mean difference was recorded between multiplanar CBCT and 3D simulation technique (0.017). Intraclass correlation coefficient was strong (>0.90) for all techniques except cephalograms.
Conclusions: The assessment of the lower third molar space differs according to the adopted imaging technique. Three-dimensional simulation technique is a useful novel technology that allows an exploration of the crown in many different dimensions and orientations, giving more predictable results than the conventional methods.
Keywords: Cephalometry; Cone Beam Computed Tomography; panoramic radiography; radiology; third molar.