Assessment of diagnostic accuracy of orthopantomogram in determining the root morphology of impacted mandibular third molars

Accurate assessment of root morphology is a key to surgical management of impacted teeth. The objective of this study was to determine the diagnostic accuracy of orthopantomogram in determining root morphology of impacted mandibular third molar tooth by taking the surgical findings as gold standard. Patients presenting in Department of Oral and Maxillofacial surgery, Punjab Dental Hospital Ide'Montmorency College of Dentistry, Lahore for impacted mandibular third molar surgery and who consented to be part of the study were included in the study. It was a cross-sectional survey with a sample size of 300 and was carried out from December 2011 to December 2012. All patients were advised an orthopantomogram before the surgery. Pre-operative radiographs were assessed and findings noted. Surgeries were carried out as per standard protocol. Post-operative root morphology was assessed and noted. In case where tooth sectioning was done, crown and root fragments were re-approximated using sticky wax. The sensitivity and specificity values of orthopantomogram in determining the root morphology of impacted mandibular third molars were 33.3% and 92.5%. It was concluded that orthopantomogram is less sensitive and more specific in assessing root curvatures of impacted mandibular third molars