{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:20:00Z","timestamp":1792196400501,"version":"4.4.0"},"reference-count":38,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014Brasil","doi-asserted-by":"publisher","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused\/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (\u03ba = 0.42) and fair agreement (\u03ba = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1\/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.<\/jats:p>","DOI":"10.3390\/medicina59111975","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T08:08:58Z","timestamp":1699517338000},"page":"1975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots"],"prefix":"10.3390","volume":"59","author":[{"given":"Marcia","family":"Almeida-Marques","sequence":"first","affiliation":[{"name":"Division of Oral Radiology, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara Magnoler Sampaio","family":"Ingold","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto Ferreira","family":"da Silva-Junior","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1417-2781","authenticated-orcid":false,"given":"Ademir","family":"Franco","sequence":"additional","affiliation":[{"name":"Division of Forensic Dentistry, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luiz Cintra","family":"Junqueira","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Caroline","family":"Oenning","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology, Faculdade S\u00e3o Leopoldo Mandic, Centro de Pesquisas S\u00e3o Leopoldo Mandic, Rua Jos\u00e9 Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1016\/j.joms.2007.04.019","article-title":"Age as a risk factor for third molar surgery complications","volume":"65","author":"Chuang","year":"2007","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.61872\/sdj-2014-10-02","article-title":"The most common complications after wisdom-tooth removal: Part 2: A retrospective study of 1562 cases in the maxilla","volume":"124","author":"Pourmand","year":"2014","journal-title":"Swiss Dent. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/j.joms.2004.05.214","article-title":"Risk factors for third molar extraction difficulty","volume":"62","author":"Susarla","year":"2004","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.bjoms.2006.10.013","article-title":"Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: Prospective multicentre study","volume":"45","author":"Rothamel","year":"2007","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.coms.2006.11.013","article-title":"Complications of third molar surgery","volume":"19","author":"Bouloux","year":"2007","journal-title":"Oral Maxillofac. Surg. Clin. North Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"5197","DOI":"10.1007\/s00784-021-03827-6","article-title":"The effect of anatomy on osteogenesis after maxillary sinus floor augmentation: A radiographic and histological analysis","volume":"25","author":"Zhou","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s10006-016-0574-1","article-title":"Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth","volume":"20","author":"Hasegawa","year":"2016","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/j.joms.2012.01.032","article-title":"Maxillary third molar: Patterns of impaction and their relation to oroantral perforation","volume":"70","author":"Lim","year":"2012","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Barone, S., Antonelli, A., Averta, F., Diodati, F., Muraca, D., Bennardo, F., and Giudice, A. (2021). Does mandibular gonial angle influence the eruption pattern of the lower third molar?. a three-dimensional study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10184057"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jormas.2021.11.003","article-title":"Qualitative and quantitative assessment of condylar displacement after orthognathic surgery: A voxel-based three-dimensional analysis","volume":"123","author":"Barone","year":"2022","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1259\/dmfr\/22263461","article-title":"Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal","volume":"41","author":"Neves","year":"2012","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e395","DOI":"10.4317\/medoral.23443","article-title":"Marginal bone loss in the second molar related to impacted mandibular third molars: Comparison between panoramic images and cone beam computed tomography","volume":"25","author":"Dias","year":"2020","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.4103\/njcp.njcp_420_17","article-title":"Evaluation of the maxillary third molars and maxillary sinus using cone-beam computed tomography","volume":"21","author":"Yurdabakan","year":"2018","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Antonelli, A., Barone, S., Bennardo, F., and Giudice, A. (2023). Three-dimensional facial swelling evaluation of pre-operative single-dose of prednisone in third molar surgery: A split-mouth randomized controlled trial. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03334-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.tripleo.2009.10.021","article-title":"Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars","volume":"109","author":"Suomalainen","year":"2010","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"233","DOI":"10.5624\/isd.2015.45.4.233","article-title":"Assessment of maxillary third molars with panoramic radiography and cone-beam computed tomography","volume":"45","author":"Jung","year":"2015","journal-title":"Imaging Sci. Dent."},{"key":"ref_17","first-page":"111","article-title":"Preoperative evaluation of third molar root characteristics: Correlation between clinical and radiographic findings","volume":"30","author":"Machado","year":"2015","journal-title":"J. Dent. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1067\/moe.2003.16","article-title":"The accuracy of dental panoramic tomographs in determining the root morphology of mandibular third molar teeth before surgery","volume":"95","author":"Bell","year":"2003","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"309","DOI":"10.5624\/isd.2020.50.4.309","article-title":"Comparison of panoramic radiography and cone-beam computed tomography for assessing radiographic signs indicating root protrusion into the maxillary sinus","volume":"50","author":"Jung","year":"2020","journal-title":"Imaging Sci. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.tripleo.2010.06.010","article-title":"Anatomy of impacted lower third molars evaluated by computerized tomography: Is there an indication for 3-dimensional imaging?","volume":"111","author":"Matthews","year":"2011","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_21","first-page":"32","article-title":"A retrospective analysis of the root morphology of maxillary and mandibular third molars","volume":"2","author":"Shivpuri","year":"2018","journal-title":"Acta Sci. Dent. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1046\/j.1365-2591.2002.00511.x","article-title":"Root and canal morphology of Thai maxillary molars","volume":"35","author":"Alavi","year":"2002","journal-title":"Int. Endod. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.sjdr.2015.03.003","article-title":"Prevalence of developmental dental anomalies among adult population of Jazan, Saudi Arabia","volume":"7","author":"Vani","year":"2016","journal-title":"Saudi J. Dent. Res."},{"key":"ref_24","first-page":"369","article-title":"Evaluation of root dilaceration by cone beam computed tomography in iranian south subpopulation: Permanent molars","volume":"23","author":"Asheghi","year":"2022","journal-title":"J. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.joen.2012.08.012","article-title":"Occurrence of hypercementosis in a German population","volume":"38","author":"Jansen","year":"2012","journal-title":"J. Endod."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"483","DOI":"10.4103\/njcp.njcp_262_20","article-title":"Prevalence of hypercementosis and frequency of possible etiological factors in a Turkish subpopulation","volume":"24","author":"Defne","year":"2021","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"724","DOI":"10.4103\/1119-3077.183254","article-title":"Evaluation of the frequency and characteristics of hypercementosis in the Turkish population with cone-bean computed tomography","volume":"20","author":"Eren","year":"2017","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"957","DOI":"10.4103\/njcp.njcp_614_18","article-title":"Radiographic evaluation and determination of hypercementosis patterns in Al-Madinah Al-Munawwarah, Saudi Arabia: A retrospective cross-sectional study","volume":"22","author":"Elsayed","year":"2019","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"94","DOI":"10.17126\/joralres.2018.022","article-title":"Prevalence of hypercementosis in a Saudi Arabian population: A cone beam computed tomography study","volume":"7","author":"Patil","year":"2018","journal-title":"J. Oral Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1055\/s-0039-1697866","article-title":"An assessment of the relationship between the maxillary sinus floor and the maxillary posterior teeth root tips using dental cone-beam computerized tomography","volume":"4","author":"Kilic","year":"2010","journal-title":"Eur. J. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s11282-015-0228-2","article-title":"Evaluation of the maxillary third molar position and its relationship with the maxillary sinus: A CBCT study","volume":"32","author":"Demirtas","year":"2015","journal-title":"Oral Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3126\/ajms.v8i1.15878","article-title":"Correlation between maxillary sinus floor topography and relative root position of posterior teeth using orthopantomograph and digital volumetric tomography","volume":"8","author":"Kalkur","year":"2017","journal-title":"Asian J. Med. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.tripleo.2005.09.031","article-title":"Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging","volume":"102","author":"Sharan","year":"2006","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s00784-013-0963-x","article-title":"Comparative assessment of panoramic radiography and CBCT imaging for radiodiagnostics in the posterior maxilla","volume":"18","author":"Shahbazian","year":"2013","journal-title":"Clin. Oral Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3363","DOI":"10.1007\/s00784-023-05048-5","article-title":"Tooth automatic segmentation from CBCT images: A systematic review","volume":"27","author":"Polizzi","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Leonardi, R., Ronsivalle, V., Isola, G., Cicci\u00f9, M., Lagrav\u00e8re, M., Flores-Mir, C., and Lo Giudice, A. (2023). External root resorption and rapid maxillary expansion in the short-term: A CBCT comparative study between tooth-borne and bone-borne appliances, using 3D imaging digital technology. BMC Oral Health, 23.","DOI":"10.1186\/s12903-023-03280-9"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s00247-017-4012-9","article-title":"Cone-beam CT in paediatric dentistry: DIMITRA project position statement","volume":"48","author":"Oenning","year":"2017","journal-title":"Pediatr. Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1111\/ipd.12797","article-title":"ALADAIP, beyond ALARA and towards personalized optimization for paediatric cone-beam CT","volume":"31","author":"Oenning","year":"2021","journal-title":"Int. J. Paediatr. Dent."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1975\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:20:03Z","timestamp":1760131203000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/11\/1975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,9]]},"references-count":38,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["medicina59111975"],"URL":"https:\/\/doi.org\/10.3390\/medicina59111975","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,9]]}}}