Comparison between two radiographic methods used for the prediction of mandibular third molar impaction | Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial

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It has been previously reported that patterns of facial growth, jaw development and tooth size are inherited and the eruption pattern differs between populations, races and gender. All these factors are crucial to the eruption pattern and impaction status of mandibular third molar that exhibit the highest rate of tooth impaction reported.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> The mandibular third molars are the most frequently impacted teeth that can be found in human without sexual dimorphisms.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a> The prevalence of the third molar impaction ranges from 16.7% to 68.8%.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Third molar impaction may be caused by inadequate space, limited skeletal growth, distal eruption of the dentition, vertical direction of condylar growth, increased crown size of impacted teeth, and the late or retarded maturation of the third molars.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Although the average age for eruption of the third molar is considered 20 years old by Garcia and Chauncey (1989), the time of the eruption shows considerable variations among populations ranging from 14 to 24 years old.<a class="elsevierStyleCrossRefs" href="#bib0025">5,6</a> The frequency of mandibular third molar impaction was 56.8% in orthodontic patients and the tooth position observed most often was mesioangular inclination with a frequency of 50.0%.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>A strategy to prevent impaction or partial eruption of the third molars need first identify when the third-molar impaction occurs. The prediction of eruption of the third molar tooth is associated with great uncertainty. An important variable to predict eruption of third molars is mesiodistal space between the distal surface of the second molar to the ascending ramus of the mandible.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Some authors were reported that if this mesiodistal space is large than the mesiodistal width of the third molar crown the probability of its eruption is approximately 70%. However third molar eruption cannot be guaranteed despite adequate space available in the jaw.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> Several methods to predict the third molar eruption have been presented using lateral radiographs, bite-wings, anterior-posterior radiographs, periapical radiographs or panoramic radiographs.<a class="elsevierStyleCrossRefs" href="#bib0050">10–15</a> The different methods included measurement of the available space,<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> mandibular size and growth<a class="elsevierStyleCrossRefs" href="#bib0050">10,12</a> and third molar angulation.<a class="elsevierStyleCrossRefs" href="#bib0070">14,16</a> Prediction in the patient during growth could be of great interest and help planning future dental treatments (orthodontic, prosthesis or surgical exodontia). Because when most dental treatments start, third molars often show a limited amount of calcification and just start to develop. Probably the excessive high rate of asymptomatic third molar extraction is due to a lack of reliable and simple predictive tools. Therefore, it is often very difficult to predict whether these teeth will erupt or remain impacted.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Third molar impaction is a major problem in modern human without interproximal attrition.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> Skull materials indicate that third molar impaction was relatively infrequent in primitive populations.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Few studies in the scientific literature have been conducted to compare different predictive methods in the prognosis of the third molar eruption.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> In fact, a high number of third molar eruption prediction methods have been described by various authors but none of these methods predicted the third molar eruption with great accuracy.<a class="elsevierStyleCrossRef" href="#bib0090">18</a>The aim of the present study was to evaluate accuracy of two different methods (Olive-Basford’<a class="elsevierStyleCrossRef" href="#bib0095">19</a> and Olmos’ methods<a class="elsevierStyleCrossRef" href="#bib0100">20</a>), used to predict the impaction of the mandibular third molar and measured on panoramic radiographs.Material and methodsThe present study was undertaken after approval by the Research Ethics Committee of the University of Santiago de Compostela. All subjects agreed to participate in the study after prior informed consultation and signed a written informed consent. Forty-two patients attending the Valladares and Olmos Clinic in Pontevedra (Spain) for orthodontic treatment were reviewed from the database. The patients with unerupted mandibular third molar at the time of the baseline (t1) evaluation were selected to participate. The subjects included in this study fulfilled the following criteria: no previous orthodontic or orthognathic surgical treatment, no missing or extracted permanent teeth, no history of medical conditions that could alter the growth or tooth eruption and all panoramic images were of good quality. The time interval between the panoramic radiographs did not exceed 3 years in the second evaluation (t2) and 6 years in the latest evaluation (t3).The radiographs of all patients were made under standard conditions with Satelec X Mind Pano Cephat machine (Satelec®, Acteon Group® Dental Equipment, France) in the baseline time (t1) and in the other two times (t2 and t3) by the same operator radiological technician (70Kvp, 16mA, analog position of patient, 20s).A total of 64 third molars were selected and the eruption status was registered. Thorough oral examination of the status of the mandibular third molar in follow-up periods ((t2 and t3) that included emergence of third molar in oral cavity (eruption) or incomplete eruption (uneruption) defined as impaction.The prediction of eruption was assessed in all third molars with two radiographic methods by the same operator (MVD) in the three evaluation times (t1, t2 and t3): Olive-Basford's and Olmos’ methods. The Olive-Basford's method<a class="elsevierStyleCrossRef" href="#bib0095">19</a> to predict eruption or impaction of the lower third molars is based on measurements of the Space-Width Ratio found by dividing the space available (AB) by the mesiodistal width of the lower third molar (CD). The occlusal plane is defined as the line drawn through the cusp tip of the first premolar and the cusps of the second molar. The measurements were done by a single operator using a right-angle T and a black ink marker waterproof extra-fine tip. The points were identified in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>: A is the point on the occlusal plane perpendicularly above the most distal point on the crown of the lower second molar. B is the intersection of the lower occlusal plane and the anterior border of the mandibular ramus. C and D mark the maximum mesiodistal width of the lower third molar. The space available AB, the mesiodistal width of the lower third molar CD, and Space-Width Ratio (AB/CD) was calculated. For a ratio AB/CD×100>120% it was assigned a future probability of eruption for a ratio, AB/CD≥1 ideal relationship to erupt; AB/CD=0.75 acceptable relationship to erupt and AB/CD<0.75 probable dental impaction.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The Olmos’ method<a class="elsevierStyleCrossRef" href="#bib0100">20</a> assesses the inclination of the mandibular third molar angle formed by the tangent through the occlusal surface of the mandibular third molar and the tangent through the occlusal surfaces of lower first molar, first and second premolars; or lower first molar and lower first and second molar and first and second lower temporary molars (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). This method determines that if the angle is less than or equal to 32°, the third molar eruption is possible, but if the angle is higher than 32°, the lower third molar has the potential to impact. The angle measurements were determined for using of a protractor on panoramic radiographs.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Qualitative variables were expressed as frequencies and percentages; quantitative variables were expressed as mean±standard deviation. The assumption of normality was analyzed through the Kolmogorov-Smirnov test. The χ2 test was used as required to compare qualitative variables. The one-way ANOVA test was used to contrast quantitative and qualitative variables.The discrimination accuracy of these methods (Olive-Basford's method and Olmos’ method) as predictors of eruption of mandibular third molar was evaluated in the three times pre-established, by using the Receiver Operating Characteristic (ROC) curve. It is a commonly used diagnostic tool, in which the Sensitivity (probability that the method classifies an erupted third molar correctly) is plotted against the 1-Specificity (probability that the method classifies incorrectly an un-erupted molar) for all possible values of the corresponding method considered as cut-points. The gold standard (true status) was the status of the third molar (erupted/un-erupted) at the end of the follow-up (t3). The information provided by the ROC curve is usually summarized in a numerical index as the area under the curve (AUC).<a class="elsevierStyleCrossRefs" href="#bib0105">21,22</a> This can be interpreted as the probability that in a randomly selected pair of un-erupted and erupted third molars, the value of the method is higher for the erupted molar. Values of AUC close to 1 indicate that the method has a high diagnostic accuracy. It was accompanied by its corresponding 95% confidence interval.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> The accuracy of two predictive methods was compared to determine the best method using the homogeneity areas test based on the statistic Chi-square statistic.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> All statistical analyses were carried out with R 2.12.0 statistical software.<a class="elsevierStyleCrossRef" href="#bib0120">24</a>ResultsA total of 64 mandibular third molar teeth (32 left and 32 right third molars) from 15 (46.88%) female and 17 (53.12%) male patients were included in this study. The average age of the subjects was 12.70±1.83 years in t1, 15.24±1.78 years in t2 and 17.9±2.45 years in t3.Three years later (t2) only one tooth erupted and at the end of the follow-up time, 6 years later (t3), 19 teeth (29.69%) were erupted in 11 patients (8 females and 3 males). Taking into account the final status of the third molar (eruption/un-eruption) in t3, no statistically significant differences were detected between the ages of the patients of these two groups in t2 and t3 (p=0.361 and p=0.986, respectively), mainly in t3, where ages were virtually the same in both groups (see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). However, there were significant differences in t1 (p≤0.001).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The means of Olive-Basford's and Olmos’ methods were calculated for each of the groups divided into erupted and un-erupted based on the t3 status for all three time intervals (see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Although Olive-Basford's method reached higher values in erupted third molars than in un-erupted molars in all times, only statistical significant differences were registered between both groups in t3 (p<0.05). For Olmos’ method there were also differences in t3 (p<0.001) but in this case with lower values in the group of final erupted third molars (see <a class="elsevierStyleCrossRefs" href="#fig0015">Figs. 3–4</a>).<elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia>The ROC curves for the two methods in each time, taking as gold standard the status of the third molar (erupted/un-erupted) at the end of the follow-up, are shown in <a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>. While in t1 and t2 the curves were more similar for both methods, in t3 differences were detected between the two curves, where the ROC curve of Olmos’ method always remained on top. This is also clearly reflected in terms of AUC.<elsevierMultimedia ident="fig0025"></elsevierMultimedia>The values of AUC for Olive-Basford's method in t1 and t2, and for Olmos’ method in t1 were not statistically significant (the 95% confidence intervals contain the 0.5 value in these cases). Moreover, although in t1 and t2, the AUC was slightly higher in the Olmos’ method, there were not statistically significant differences between the accuracy discrimination of both methods (p=0.483 and p=0.552, respectively). However, in t3, significant differences were detected (p<0.05), where the AUC for Olmos’ method was 0.874 (95% CI: 0.788–0.959) (see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), showing a high discrimination capacity of the Olmos’ method in t3 (the AUC value is elevated, close to 1 in the 87% of the cases, the value of the Olmos’ method is higher for the erupted molar than for the un-erupted molar).DiscussionThe eruption of the mandibular third molar is a complex multifactorial process because neither the eruption mechanism nor the contributors’ factors in the process are completely understood. The third molars are generally the last teeth to erupt into the arches and as a consequence they are also the most frequently impacted teeth. While many factors may affect the eruption of mandibular third molars, it has been established that the eruption of the third molar is primarily dependent upon the available space conditions at the posterior ends of the arch. Despite this apparently simple approach to planning tooth-extraction, the clinical controversy about asymptomatic third molar extraction and time of exodontia is still largely unresolved.In previous studies, lateral cephalometric radiographs and rotational panoramic radiographs were used to estimate the presence of space for the third molar and they also were used to estimate the retromolar space/third molar crown width ratio to assess the third molar eruption.<a class="elsevierStyleCrossRefs" href="#bib0065">13,16,25–27</a> However, panoramic radiography yielded one of the most accurate estimations in this field<a class="elsevierStyleCrossRefs" href="#bib0095">19,27</a> and it is the most popular dental record for the clinician, since it has been a common research tool for assessing lower third molars for extraction.<a class="elsevierStyleCrossRefs" href="#bib0040">8,26</a> In this study, were selected panoramic radiographs because they are the usual radiological exploration modality for dental screening in dental clinic. The radiographs were obtained by a single experienced operator, in the same machine, which reduced possible error related to the radiographic technique. Despite the fact that they cause magnification and distortion of the image, panoramic radiographs allow the measurements of the angles and the consistency between measurements can be assessed if the device and the settings are the same.<a class="elsevierStyleCrossRefs" href="#bib0140">27,28</a> The distortion in the position of mandibular third molars on panoramic radiographs may influence the surgical planning; however, this does not invalidate it as the main tool for diagnosis of mandibular third molar.<a class="elsevierStyleCrossRef" href="#bib0155">29</a>Initially many lower third molars have a mesial inclination but they progressively become more upright up to the age of 25 and the teeth may erupt normally, usually between the ages of 18 and 24.<a class="elsevierStyleCrossRefs" href="#bib0030">6,11</a> The eruption may be prevented by the lack of space, so they become impacted. It has been previously reported that the retromolar space and mesiodistal angulation of impacted tooth are the most important factors for the eruption of third molars.<a class="elsevierStyleCrossRefs" href="#bib0040">8,10,21</a> Therefore these variables that describe spaces between the anterior of the ramus and the distal of the mandibular second molar and tooth size seemed to be the primary contributors to be observed between the non-impaction and the impaction groups studied. Other authors observed that there was also a significant difference in retromolar space/third molar crown width ratio. In such cases, when the crown width is larger than the retromolar space, the impacted tooth should be removed surgically by tooth sectioning or root sectioning in order to remove less bone around the impacted tooth. For all these reasons we have considered to use two different methods with linear and angular measurements in this study. In a previous study was observed that facial growth pattern and root configurations did not affect third molar impaction while the retromolar space of third molar was significantly smaller in the impacted group. In addition, retromolar space/third molar crown width ratio was significantly smaller in the impacted group.<a class="elsevierStyleCrossRef" href="#bib0150">30</a>The protocol study has not taken into account the sexual dimorphism because the third molars behave differently to the other teeth; mature and erupt earlier in female subjects. Some authors concluded that the right and left mandibular molars have the same pattern of development and emergence and over the age of 18, no relevant differences were observed between sexes.<a class="elsevierStyleCrossRefs" href="#bib0015">3,4</a>Clinical assessment through the use of reliable and simple predictive tools is essential for evaluating the eruption of the mandibular third molar. This study has been developed for analyzing the capacity of discrimination in prediction of the eruption of the third molar of two different methods on panoramic radiographs. In our study, the results of the Olive-Basford's method increased while the Olmos’ method decreased with time. This shows that, as expected, over time, the discriminatory power of both methods was increased, making it easier to detect the possible eruption of the third molar. The older patient age gets the better prediction in both methods because the time factor determines the evolution of the eruptive process. One of the strengths of the present study is that in t3 (time closest to the possible eruption of third molar) it is shown that there were significant differences (p<0.05), and the capacity of discrimination of Olmos’ method was significantly higher than Olive-Basford's method. So, the discrimination of Olmos’ method was significantly higher than Olive-Basford's method 6 years later. This clinically means that the Olmos’ method could be used as a good method for discriminate in t3 between erupted and unerupted ones in clinical practice.Other strength of this study was the criterion for patient selection and monitoring protocol followed. In most studies, the criteria used for determination of eruption status were emergence of any portion of the crown through the oral mucosa. This can give misleading results because many of the mandibular third molars do not continue to erupt and remain impacted in a partially erupted position.The findings have determined an easy clinically applicable method for identify the probability of eruption or uneruption of the mandibular third molar based on panoramic radiographic measurements. Although it could be critical to the number of patients, this is a follow-up study for 6 years in patients with mandibular third molars without orthodontic treatment and the material is suitable.Moreover, the present results are in agreement with a previous one.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> When they compared the prognosis of third molar eruption assessed by three different cephalometric methods employed panoramic radiographs: the Olive's method, the Ganss’ method and Venta's method, they determined that the Olive's method results in over-prediction compared with the other methods. The authors concluded that the three methods were not found to be reliable or accurate. They suggest that the methods used are only suited to the racial characteristics of those populations from whom they were originally extrapolate (North American population, Northern Germans population or Finnish population) and they would be inappropriate for populations of mediterranean origin.<a class="elsevierStyleCrossRef" href="#bib0085">17</a>In the present study, were compared two different predictive methods by the analysis of the retromolar space and the direction of eruption, factors that were considered the most important in the third molar eruption. So, the predictive methods selected should be tested on a higher number of teeth due to the small number of teeth erupted in t2 and the range of application could be extended to younger ages. The results of this study show that the Olmos’ method could be more robust for Galician population.ConclusionThe Olmos’ method demonstrated utility in assessment of eruption prediction of third mandibular molars in clinical practice with patients previous orthodontic treatment.Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this study.Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data.Right to privacy and informed consentThe authors declare that no patient data appear in this article.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres390696" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objectives" 2 => "Methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec368831" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres390697" "titulo" => array:5 [ 0 => "Resumo" 1 => "Objetivos" 2 => "Métodos" 3 => "Resultados" 4 => "Conclusões" ] ] 3 => array:2 [ "identificador" => "xpalclavsec368830" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:3 [ "identificador" => "sec0030" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Right to privacy and informed consent" ] ] ] 10 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-03-26" "fechaAceptado" => "2014-10-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec368831" "palabras" => array:5 [ 0 => "Impacted tooth" 1 => "Mandibular third molar" 2 => "Panoramic radiography" 3 => "Cephalometry" 4 => "Prognosis" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec368830" "palabras" => array:5 [ 0 => "Impactação dentária" 1 => "Terceiro molar inferior" 2 => "Radiografias panorâmicas" 3 => "Cefalometria" 4 => "Prognóstico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "ObjectivesThis study compares the validity of two different methods with linear and angular measurements (Olive-Basford's method and Olmos’ method) used as predictive methods of mandibular third molar impaction. MethodsA long-term follow-up study analyzing measurements over dental panoramic radiographs in three consecutive times (at the time of baseline evaluation (t1) and 3 (t2) and 6 (t3) years later) during six years was realized in 32 orthodontic patients. The discrimination accuracy in each time was evaluated by using the Receiver Operating Characteristic (ROC) curve. ResultsThe area under the ROC curve (AUC) in t1 and t2 was slightly higher in the Olmos’ method, but there were no statistically significant differences between both methods (p=0.483 and p=0.552, respectively). However, in t3, significant differences were detected (p<0.05), where the AUC for Olmos’ method was 0.874 (95% CI: 0.788–0.959), showing a high discrimination capacity of this method. ConclusionsThe Olmos’ method improves the prediction of the third molar eruption, allowing a higher level of discrimination in clinical practice to identify the likelihood of impaction on panoramic radiographs." ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "ObjetivosEste estudo compara a validade de 2 métodos diferentes, com medidas lineares e angulares (método de Olive-Basford e método de Olmos) usados como métodos preditivos da impactação do terceiro molar mandibular. MétodosUm estudo de seguimento analisa as medições sobre radiografias panorâmicas em 3 vezes consecutivas (no momento da avaliação inicial [T1], 3 anos [T2] e 6 anos [T3]), durante 6 anos, realizado em 32 pacientes ortodônticos. A precisão da discriminação em cada tempo foi avaliada usando o Receiver Operating Characteristic (ROC). ResultadosA área sob a curva ROC (AUC) em T1 e T2 foi ligeiramente superior no método de Olmos, mas não houve diferenças estatisticamente significativas entre os 2 métodos (p=0,483 e p=0,552, respetivamente). Entretanto, em T3, foram detetadas diferenças significativas (p<0,05) em que a AUC para o método de Olmos foi 0,874 (IC 95%: 0,788-0,959), que mostra uma alta capacidade de discriminação deste método. ConclusõesO método de Olmos demonstrou permitir uma maior capacidade de previsão de erupção do terceiro molar na prática clínica e da probabilidade de impactação através da análise de radiografias panorâmicas." ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 750 "Ancho" => 995 "Tamanyo" => 173513 ] ] "descripcion" => array:1 [ "en" => "Olive-Basford's method." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 764 "Ancho" => 995 "Tamanyo" => 192552 ] ] "descripcion" => array:1 [ "en" => "Olmos’ method." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 988 "Ancho" => 1683 "Tamanyo" => 126903 ] ] "descripcion" => array:1 [ "en" => "Distribution Olive-Basford's and Olmos’ methods in erupted and un-erupted group at the end of the follow-up time." ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1382 "Ancho" => 2267 "Tamanyo" => 178633 ] ] "descripcion" => array:1 [ "en" => "Box-plots Olive-Basford's and Olmos’ methods in erupted and un-erupted group." ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1911 "Ancho" => 2574 "Tamanyo" => 216163 ] ] "descripcion" => array:1 [ "en" => "ROC curves Olive-Basford's Method and Olmos’ Method in each time." ] ] 5 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Erupted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Un-erupted \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">n</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 third molars (29.69%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 third molars (70.31%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 patients (34.38%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 patients (65.62%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 females (72.73%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 females (33.33%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 males (27.27%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 males (66.67%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.58±1.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.18±1.88 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.92±1.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.37±1.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.98±1.70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.99±0.72 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab602474.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of study sample by gender and age in erupted and un-erupted third molars at final follow-up time." ] ] 6 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Olive Basford's method</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Olmos’ method</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Erupted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Un-erupted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Erupted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Un-erupted \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t1</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.53±0.24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.50±0.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51±0.28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.74±13.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.64±11.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41.78±11.74 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AUC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.520 (0.371–0.670)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.598 (0.440–0.756)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t2</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.70±0.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.61±0.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.64±0.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33±6.02 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36.51±9.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.47±9.07 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AUC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.585 (0.421–0.749)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.651 (0.510–0.791)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">t3</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.87±0.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.71±0.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.76±0.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.26±11.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34.02±14.63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.86±16.78 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AUC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.668 (0.530–0.806)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.874 (0.788–0.959)</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab602473.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Mean values and AUCs for Olive Basford's and Olmos’ methods in erupted and un-erupted third molars at final follow-up time." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiographic evaluation of mandibular third molar eruption space" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.N. 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Original research

Comparison between two radiographic methods used for the prediction of mandibular third molar impaction

Comparação entre 2 métodos radiográficos diferentes usados para a previsão da impactação do terceiro molar mandibular

Maria Mercedes Gallas-Torreiraa,

Corresponding author

mercedes.gallas.torreira@usc.es

Corresponding author.

, Maria Valladares-Duránb, Mónica López-Ratónc

a School of Dentistry, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain

b Stomatology Department, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain

c Statistics and Operations Research Department, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The third molar eruption is a complex multifactorial process&#46; It has been previously reported that patterns of facial growth&#44; jaw development and tooth size are inherited and the eruption pattern differs between populations&#44; races and gender&#46; All these factors are crucial to the eruption pattern and impaction status of mandibular third molar that exhibit the highest rate of tooth impaction reported&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The mandibular third molars are the most frequently impacted teeth that can be found in human without sexual dimorphisms&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> The prevalence of the third molar impaction ranges from 16&#46;7&#37; to 68&#46;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Third molar impaction may be caused by inadequate space&#44; limited skeletal growth&#44; distal eruption of the dentition&#44; vertical direction of condylar growth&#44; increased crown size of impacted teeth&#44; and the late or retarded maturation of the third molars&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although the average age for eruption of the third molar is considered 20 years old by Garcia and Chauncey &#40;1989&#41;&#44; the time of the eruption shows considerable variations among populations ranging from 14 to 24 years old&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> The frequency of mandibular third molar impaction was 56&#46;8&#37; in orthodontic patients and the tooth position observed most often was mesioangular inclination with a frequency of 50&#46;0&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A strategy to prevent impaction or partial eruption of the third molars need first identify when the third-molar impaction occurs&#46; The prediction of eruption of the third molar tooth is associated with great uncertainty&#46; An important variable to predict eruption of third molars is mesiodistal space between the distal surface of the second molar to the ascending ramus of the mandible&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Some authors were reported that if this mesiodistal space is large than the mesiodistal width of the third molar crown the probability of its eruption is approximately 70&#37;&#46; However third molar eruption cannot be guaranteed despite adequate space available in the jaw&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Several methods to predict the third molar eruption have been presented using lateral radiographs&#44; bite-wings&#44; anterior-posterior radiographs&#44; periapical radiographs or panoramic radiographs&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;15</span></a> The different methods included measurement of the available space&#44;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> mandibular size and growth<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;12</span></a> and third molar angulation&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;16</span></a> Prediction in the patient during growth could be of great interest and help planning future dental treatments &#40;orthodontic&#44; prosthesis or surgical exodontia&#41;&#46; Because when most dental treatments start&#44; third molars often show a limited amount of calcification and just start to develop&#46; Probably the excessive high rate of asymptomatic third molar extraction is due to a lack of reliable and simple predictive tools&#46; Therefore&#44; it is often very difficult to predict whether these teeth will erupt or remain impacted&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Third molar impaction is a major problem in modern human without interproximal attrition&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Skull materials indicate that third molar impaction was relatively infrequent in primitive populations&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Few studies in the scientific literature have been conducted to compare different predictive methods in the prognosis of the third molar eruption&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In fact&#44; a high number of third molar eruption prediction methods have been described by various authors but none of these methods predicted the third molar eruption with great accuracy&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of the present study was to evaluate accuracy of two different methods &#40;Olive-Basford&#8217;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> and Olmos&#8217; methods<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#41;&#44; used to predict the impaction of the mandibular third molar and measured on panoramic radiographs&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">The present study was undertaken after approval by the Research Ethics Committee of the University of Santiago de Compostela&#46; All subjects agreed to participate in the study after prior informed consultation and signed a written informed consent&#46; Forty-two patients attending the Valladares and Olmos Clinic in Pontevedra &#40;Spain&#41; for orthodontic treatment were reviewed from the database&#46; The patients with unerupted mandibular third molar at the time of the baseline &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span>&#41; evaluation were selected to participate&#46; The subjects included in this study fulfilled the following criteria&#58; no previous orthodontic or orthognathic surgical treatment&#44; no missing or extracted permanent teeth&#44; no history of medical conditions that could alter the growth or tooth eruption and all panoramic images were of good quality&#46; The time interval between the panoramic radiographs did not exceed 3 years in the second evaluation &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span>&#41; and 6 years in the latest evaluation &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The radiographs of all patients were made under standard conditions with Satelec X Mind Pano Cephat machine &#40;Satelec<span class="elsevierStyleSup">&#174;</span>&#44; Acteon Group<span class="elsevierStyleSup">&#174;</span> Dental Equipment&#44; France&#41; in the baseline time &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span>&#41; and in the other two times &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41; by the same operator radiological technician &#40;70<span class="elsevierStyleHsp" style=""></span>Kvp&#44; 16<span class="elsevierStyleHsp" style=""></span>mA&#44; analog position of patient&#44; 20<span class="elsevierStyleHsp" style=""></span>s&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A total of 64 third molars were selected and the eruption status was registered&#46; Thorough oral examination of the status of the mandibular third molar in follow-up periods &#40;&#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41; that included emergence of third molar in oral cavity &#40;eruption&#41; or incomplete eruption &#40;uneruption&#41; defined as impaction&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The prediction of eruption was assessed in all third molars with two radiographic methods by the same operator &#40;MVD&#41; in the three evaluation times &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span>&#44; <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41;&#58; Olive-Basford&#39;s and Olmos&#8217; methods&#46; The Olive-Basford&#39;s method<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> to predict eruption or impaction of the lower third molars is based on measurements of the Space-Width Ratio found by dividing the space available &#40;AB&#41; by the mesiodistal width of the lower third molar &#40;CD&#41;&#46; The occlusal plane is defined as the line drawn through the cusp tip of the first premolar and the cusps of the second molar&#46; The measurements were done by a single operator using a right-angle T and a black ink marker waterproof extra-fine tip&#46; The points were identified in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#58; A is the point on the occlusal plane perpendicularly above the most distal point on the crown of the lower second molar&#46; B is the intersection of the lower occlusal plane and the anterior border of the mandibular ramus&#46; C and D mark the maximum mesiodistal width of the lower third molar&#46; The space available AB&#44; the mesiodistal width of the lower third molar CD&#44; and Space-Width Ratio &#40;AB&#47;CD&#41; was calculated&#46; For a ratio AB&#47;CD<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>100<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>120&#37; it was assigned a future probability of eruption for a ratio&#44; AB&#47;CD<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>1 ideal relationship to erupt&#59; AB&#47;CD<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;75 acceptable relationship to erupt and AB&#47;CD<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;75 probable dental impaction&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The Olmos&#8217; method<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> assesses the inclination of the mandibular third molar angle formed by the tangent through the occlusal surface of the mandibular third molar and the tangent through the occlusal surfaces of lower first molar&#44; first and second premolars&#59; or lower first molar and lower first and second molar and first and second lower temporary molars &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; This method determines that if the angle is less than or equal to 32&#176;&#44; the third molar eruption is possible&#44; but if the angle is higher than 32&#176;&#44; the lower third molar has the potential to impact&#46; The angle measurements were determined for using of a protractor on panoramic radiographs&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Qualitative variables were expressed as frequencies and percentages&#59; quantitative variables were expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#46; The assumption of normality was analyzed through the Kolmogorov-Smirnov test&#46; The <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test was used as required to compare qualitative variables&#46; The one-way ANOVA test was used to contrast quantitative and qualitative variables&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The discrimination accuracy of these methods &#40;Olive-Basford&#39;s method and Olmos&#8217; method&#41; as predictors of eruption of mandibular third molar was evaluated in the three times pre-established&#44; by using the Receiver Operating Characteristic &#40;ROC&#41; curve&#46; It is a commonly used diagnostic tool&#44; in which the Sensitivity &#40;probability that the method classifies an erupted third molar correctly&#41; is plotted against the 1-Specificity &#40;probability that the method classifies incorrectly an un-erupted molar&#41; for all possible values of the corresponding method considered as cut-points&#46; The gold standard &#40;true status&#41; was the status of the third molar &#40;erupted&#47;un-erupted&#41; at the end of the follow-up &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41;&#46; The information provided by the ROC curve is usually summarized in a numerical index as the area under the curve &#40;AUC&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> This can be interpreted as the probability that in a randomly selected pair of un-erupted and erupted third molars&#44; the value of the method is higher for the erupted molar&#46; Values of AUC close to 1 indicate that the method has a high diagnostic accuracy&#46; It was accompanied by its corresponding 95&#37; confidence interval&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> The accuracy of two predictive methods was compared to determine the best method using the homogeneity areas test based on the statistic Chi-square statistic&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> All statistical analyses were carried out with R 2&#46;12&#46;0 statistical software&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">A total of 64 mandibular third molar teeth &#40;32 left and 32 right third molars&#41; from 15 &#40;46&#46;88&#37;&#41; female and 17 &#40;53&#46;12&#37;&#41; male patients were included in this study&#46; The average age of the subjects was 12&#46;70<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;83 years in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span>&#44; 15&#46;24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;78 years in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and 17&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;45 years in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Three years later &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span>&#41; only one tooth erupted and at the end of the follow-up time&#44; 6 years later &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41;&#44; 19 teeth &#40;29&#46;69&#37;&#41; were erupted in 11 patients &#40;8 females and 3 males&#41;&#46; Taking into account the final status of the third molar &#40;eruption&#47;un-eruption&#41; in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#44; no statistically significant differences were detected between the ages of the patients of these two groups in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;361 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;986&#44; respectively&#41;&#44; mainly in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#44; where ages were virtually the same in both groups &#40;see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; However&#44; there were significant differences in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The means of Olive-Basford&#39;s and Olmos&#8217; methods were calculated for each of the groups divided into erupted and un-erupted based on the <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> status for all three time intervals &#40;see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Although Olive-Basford&#39;s method reached higher values in erupted third molars than in un-erupted molars in all times&#44; only statistical significant differences were registered between both groups in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; For Olmos&#8217; method there were also differences in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; but in this case with lower values in the group of final erupted third molars &#40;see <a class="elsevierStyleCrossRefs" href="#fig0015">Figs&#46; 3&#8211;4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The ROC curves for the two methods in each time&#44; taking as gold standard the status of the third molar &#40;erupted&#47;un-erupted&#41; at the end of the follow-up&#44; are shown in <a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#46; While in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> the curves were more similar for both methods&#44; in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> differences were detected between the two curves&#44; where the ROC curve of Olmos&#8217; method always remained on top&#46; This is also clearly reflected in terms of AUC&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The values of AUC for Olive-Basford&#39;s method in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span>&#44; and for Olmos&#8217; method in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> were not statistically significant &#40;the 95&#37; confidence intervals contain the 0&#46;5 value in these cases&#41;&#46; Moreover&#44; although in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span>&#44; the AUC was slightly higher in the Olmos&#8217; method&#44; there were not statistically significant differences between the accuracy discrimination of both methods &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;483 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;552&#44; respectively&#41;&#46; However&#44; in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#44; significant differences were detected &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; where the AUC for Olmos&#8217; method was 0&#46;874 &#40;95&#37; CI&#58; 0&#46;788&#8211;0&#46;959&#41; &#40;see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; showing a high discrimination capacity of the Olmos&#8217; method in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> &#40;the AUC value is elevated&#44; close to 1 in the 87&#37; of the cases&#44; the value of the Olmos&#8217; method is higher for the erupted molar than for the un-erupted molar&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">The eruption of the mandibular third molar is a complex multifactorial process because neither the eruption mechanism nor the contributors&#8217; factors in the process are completely understood&#46; The third molars are generally the last teeth to erupt into the arches and as a consequence they are also the most frequently impacted teeth&#46; While many factors may affect the eruption of mandibular third molars&#44; it has been established that the eruption of the third molar is primarily dependent upon the available space conditions at the posterior ends of the arch&#46; Despite this apparently simple approach to planning tooth-extraction&#44; the clinical controversy about asymptomatic third molar extraction and time of exodontia is still largely unresolved&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In previous studies&#44; lateral cephalometric radiographs and rotational panoramic radiographs were used to estimate the presence of space for the third molar and they also were used to estimate the retromolar space&#47;third molar crown width ratio to assess the third molar eruption&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;16&#44;25&#8211;27</span></a> However&#44; panoramic radiography yielded one of the most accurate estimations in this field<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;27</span></a> and it is the most popular dental record for the clinician&#44; since it has been a common research tool for assessing lower third molars for extraction&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;26</span></a> In this study&#44; were selected panoramic radiographs because they are the usual radiological exploration modality for dental screening in dental clinic&#46; The radiographs were obtained by a single experienced operator&#44; in the same machine&#44; which reduced possible error related to the radiographic technique&#46; Despite the fact that they cause magnification and distortion of the image&#44; panoramic radiographs allow the measurements of the angles and the consistency between measurements can be assessed if the device and the settings are the same&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">27&#44;28</span></a> The distortion in the position of mandibular third molars on panoramic radiographs may influence the surgical planning&#59; however&#44; this does not invalidate it as the main tool for diagnosis of mandibular third molar&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">29</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Initially many lower third molars have a mesial inclination but they progressively become more upright up to the age of 25 and the teeth may erupt normally&#44; usually between the ages of 18 and 24&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;11</span></a> The eruption may be prevented by the lack of space&#44; so they become impacted&#46; It has been previously reported that the retromolar space and mesiodistal angulation of impacted tooth are the most important factors for the eruption of third molars&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;10&#44;21</span></a> Therefore these variables that describe spaces between the anterior of the ramus and the distal of the mandibular second molar and tooth size seemed to be the primary contributors to be observed between the non-impaction and the impaction groups studied&#46; Other authors observed that there was also a significant difference in retromolar space&#47;third molar crown width ratio&#46; In such cases&#44; when the crown width is larger than the retromolar space&#44; the impacted tooth should be removed surgically by tooth sectioning or root sectioning in order to remove less bone around the impacted tooth&#46; For all these reasons we have considered to use two different methods with linear and angular measurements in this study&#46; In a previous study was observed that facial growth pattern and root configurations did not affect third molar impaction while the retromolar space of third molar was significantly smaller in the impacted group&#46; In addition&#44; retromolar space&#47;third molar crown width ratio was significantly smaller in the impacted group&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The protocol study has not taken into account the sexual dimorphism because the third molars behave differently to the other teeth&#59; mature and erupt earlier in female subjects&#46; Some authors concluded that the right and left mandibular molars have the same pattern of development and emergence and over the age of 18&#44; no relevant differences were observed between sexes&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Clinical assessment through the use of reliable and simple predictive tools is essential for evaluating the eruption of the mandibular third molar&#46; This study has been developed for analyzing the capacity of discrimination in prediction of the eruption of the third molar of two different methods on panoramic radiographs&#46; In our study&#44; the results of the Olive-Basford&#39;s method increased while the Olmos&#8217; method decreased with time&#46; This shows that&#44; as expected&#44; over time&#44; the discriminatory power of both methods was increased&#44; making it easier to detect the possible eruption of the third molar&#46; The older patient age gets the better prediction in both methods because the time factor determines the evolution of the eruptive process&#46; One of the strengths of the present study is that in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> &#40;time closest to the possible eruption of third molar&#41; it is shown that there were significant differences &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; and the capacity of discrimination of Olmos&#8217; method was significantly higher than Olive-Basford&#39;s method&#46; So&#44; the discrimination of Olmos&#8217; method was significantly higher than Olive-Basford&#39;s method 6 years later&#46; This clinically means that the Olmos&#8217; method could be used as a good method for discriminate in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span> between erupted and unerupted ones in clinical practice&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Other strength of this study was the criterion for patient selection and monitoring protocol followed&#46; In most studies&#44; the criteria used for determination of eruption status were emergence of any portion of the crown through the oral mucosa&#46; This can give misleading results because many of the mandibular third molars do not continue to erupt and remain impacted in a partially erupted position&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The findings have determined an easy clinically applicable method for identify the probability of eruption or uneruption of the mandibular third molar based on panoramic radiographic measurements&#46; Although it could be critical to the number of patients&#44; this is a follow-up study for 6 years in patients with mandibular third molars without orthodontic treatment and the material is suitable&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Moreover&#44; the present results are in agreement with a previous one&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> When they compared the prognosis of third molar eruption assessed by three different cephalometric methods employed panoramic radiographs&#58; the Olive&#39;s method&#44; the Ganss&#8217; method and Venta&#39;s method&#44; they determined that the Olive&#39;s method results in over-prediction compared with the other methods&#46; The authors concluded that the three methods were not found to be reliable or accurate&#46; They suggest that the methods used are only suited to the racial characteristics of those populations from whom they were originally extrapolate &#40;North American population&#44; Northern Germans population or Finnish population&#41; and they would be inappropriate for populations of mediterranean origin&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In the present study&#44; were compared two different predictive methods by the analysis of the retromolar space and the direction of eruption&#44; factors that were considered the most important in the third molar eruption&#46; So&#44; the predictive methods selected should be tested on a higher number of teeth due to the small number of teeth erupted in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> and the range of application could be extended to younger ages&#46; The results of this study show that the Olmos&#8217; method could be more robust for Galician population&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusion</span><p id="par0130" class="elsevierStylePara elsevierViewall">The Olmos&#8217; method demonstrated utility in assessment of eruption prediction of third mandibular molars in clinical practice with patients previous orthodontic treatment&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical disclosures</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of human and animal subjects</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidentiality of data</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Right to privacy and informed consent</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study compares the validity of two different methods with linear and angular measurements &#40;Olive-Basford&#39;s method and Olmos&#8217; method&#41; used as predictive methods of mandibular third molar impaction&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A long-term follow-up study analyzing measurements over dental panoramic radiographs in three consecutive times &#40;at the time of baseline evaluation &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span>&#41; and 3 &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span>&#41; and 6 &#40;<span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#41; years later&#41; during six years was realized in 32 orthodontic patients&#46; The discrimination accuracy in each time was evaluated by using the Receiver Operating Characteristic &#40;ROC&#41; curve&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The area under the ROC curve &#40;AUC&#41; in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">1</span> and <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">2</span> was slightly higher in the Olmos&#8217; method&#44; but there were no statistically significant differences between both methods &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;483 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;552&#44; respectively&#41;&#46; However&#44; in <span class="elsevierStyleItalic">t</span><span class="elsevierStyleInf">3</span>&#44; significant differences were detected &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; where the AUC for Olmos&#8217; method was 0&#46;874 &#40;95&#37; CI&#58; 0&#46;788&#8211;0&#46;959&#41;&#44; showing a high discrimination capacity of this method&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The Olmos&#8217; method improves the prediction of the third molar eruption&#44; allowing a higher level of discrimination in clinical practice to identify the likelihood of impaction on panoramic radiographs&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Este estudo compara a validade de 2 m&#233;todos diferentes&#44; com medidas lineares e angulares &#40;m&#233;todo de Olive-Basford e m&#233;todo de Olmos&#41; usados como m&#233;todos preditivos da impacta&#231;&#227;o do terceiro molar mandibular&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Um estudo de seguimento analisa as medi&#231;&#245;es sobre radiografias panor&#226;micas em 3 vezes consecutivas &#40;no momento da avalia&#231;&#227;o inicial &#91;T1&#93;&#44; 3 anos &#91;T2&#93; e 6 anos &#91;T3&#93;&#41;&#44; durante 6 anos&#44; realizado em 32 pacientes ortod&#244;nticos&#46; A precis&#227;o da discrimina&#231;&#227;o em cada tempo foi avaliada usando o Receiver Operating Characteristic &#40;ROC&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A &#225;rea sob a curva ROC &#40;AUC&#41; em T1 e T2 foi ligeiramente superior no m&#233;todo de Olmos&#44; mas n&#227;o houve diferen&#231;as estatisticamente significativas entre os 2 m&#233;todos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;483 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;552&#44; respetivamente&#41;&#46; Entretanto&#44; em T3&#44; foram detetadas diferen&#231;as significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; em que a AUC para o m&#233;todo de Olmos foi 0&#44;874 &#40;IC 95&#37;&#58; 0&#44;788-0&#44;959&#41;&#44; que mostra uma alta capacidade de discrimina&#231;&#227;o deste m&#233;todo&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O m&#233;todo de Olmos demonstrou permitir uma maior capacidade de previs&#227;o de erup&#231;&#227;o do terceiro molar na pr&#225;tica cl&#237;nica e da probabilidade de impacta&#231;&#227;o atrav&#233;s da an&#225;lise de radiografias panor&#226;micas&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 third molars &#40;29&#46;69&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45 third molars &#40;70&#46;31&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Mean values and AUCs for Olive Basford&#39;s and Olmos&#8217; methods in erupted and un-erupted third molars at final follow-up time&#46;</p>"
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      "titulo" => "References"
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                    0 => array:2 [
                      "titulo" => "Radiographic evaluation of mandibular third molar eruption space"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "F&#46;N&#46; Hattab"
                            1 => "E&#46;S&#46; Alhaija"
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                        "tituloSerie" => "Oral Surg Oral Med Oral Pathol Oral Radiol Endod"
                        "fecha" => "1999"
                        "volumen" => "88"
                        "paginaInicial" => "285"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10503855"
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                    0 => array:2 [
                      "titulo" => "Factors associated with mandibular third molar eruption and impaction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;H&#46; Tsai"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pediatr Dent"
                        "fecha" => "2005"
                        "volumen" => "30"
                        "paginaInicial" => "109"
                        "paginaFinal" => "114"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16491963"
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                      "titulo" => "Morphologic analysis of third-molar maturity by digital orthopantomographic assessment"
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Article information

ISSN: 16462890
Original language: English

DOI:10.1016/j.rpemd.2014.10.001

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 October	31	2	33
2024 September	55	5	60
2024 August	65	1	66
2024 July	43	4	47
2024 June	29	4	33
2024 May	27	4	31
2024 April	35	14	49
2024 March	53	5	58
2024 February	52	16	68
2024 January	40	7	47
2023 December	51	14	65
2023 November	58	19	77
2023 October	48	11	59
2023 September	76	3	79
2023 August	46	8	54
2023 July	28	7	35
2023 June	35	1	36
2023 May	49	8	57
2023 April	36	10	46
2023 March	53	3	56
2023 February	43	1	44
2023 January	44	5	49
2022 December	53	7	60
2022 November	45	8	53
2022 October	31	8	39
2022 September	37	7	44
2022 August	42	11	53
2022 July	34	10	44
2022 June	43	12	55
2022 May	22	3	25
2022 April	42	15	57
2022 March	47	12	59
2022 February	44	5	49
2022 January	63	15	78
2021 December	40	11	51
2021 November	62	13	75
2021 October	45	13	58
2021 September	53	15	68
2021 August	55	7	62
2021 July	21	9	30
2021 June	31	8	39
2021 May	24	7	31
2021 April	73	5	78
2021 March	37	4	41
2021 February	30	8	38
2021 January	35	11	46
2020 December	21	5	26
2020 November	23	8	31
2020 October	9	3	12
2020 September	25	10	35
2020 August	36	6	42
2020 July	49	4	53
2020 June	27	6	33
2020 May	47	5	52
2020 April	24	2	26
2020 March	29	7	36
2020 February	43	6	49
2020 January	25	3	28
2019 December	30	4	34
2019 November	30	3	33
2019 October	37	1	38
2019 September	46	5	51
2019 August	78	1	79
2019 July	113	16	129
2019 June	139	5	144
2019 May	135	4	139
2019 April	132	4	136
2019 March	163	2	165
2019 February	170	3	173
2019 January	193	3	196
2018 December	191	5	196
2018 November	173	7	180
2018 October	152	1	153
2018 September	49	9	58
2018 August	30	7	37
2018 July	19	7	26
2018 June	38	6	44
2018 May	45	13	58
2018 April	73	3	76
2018 March	85	13	98
2018 February	95	4	99
2018 January	51	9	60
2017 December	90	8	98
2017 November	59	14	73
2017 October	23	4	27
2017 September	24	9	33
2017 August	24	8	32
2017 July	25	15	40
2017 June	31	8	39
2017 May	33	15	48
2017 April	20	4	24
2017 March	23	2	25
2017 February	27	4	31
2017 January	36	3	39
2016 December	36	14	50
2016 November	22	5	27
2016 October	43	4	47
2016 September	13	9	22
2016 August	19	4	23
2016 July	5	6	11
2016 May	2	0	2
2016 April	28	1	29
2016 March	32	15	47
2016 February	53	23	76
2016 January	40	12	52
2015 December	46	18	64
2015 November	27	16	43
2015 October	36	15	51
2015 September	36	18	54
2015 August	55	18	73
2015 July	25	6	31
2015 June	23	4	27
2015 May	37	14	51
2015 April	64	23	87
2015 March	127	53	180
2015 February	89	48	137
2015 January	101	45	146
2014 December	68	28	96

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