Imaging Sci Dent.  2011 Sep;41(3):115-121. 10.5624/isd.2011.41.3.115.

A modified device for intraoral radiography to assess the distal osseous defects of mandibular second molar after impacted third molar surgery

• Ana FI
• Mercedes G

• KMID: 1449956
• DOI: http://doi.org/10.5624/isd.2011.41.3.115

Abstract

PURPOSE
This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery.
MATERIALS AND METHODS
A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point.
RESULTS
This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs.
CONCLUSION
This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.

Keyword

Radiography, Dental; Alveolar Bone Loss; Periodontal Attachment Loss; Molar, Third

MeSH Terms

Alveolar Bone Loss
Molar
Molar, Third
Periodontal Attachment Loss
Radiography, Dental
Stents

Figure

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  Fig. 1 A. Hollow cylinder adapted to the X-ray film positioner (posterior system Rinn® XCP Instrument Kit, Dentsply, Elgin, IL, USA) with a bite-block customized with acrylic resin (Pattern Resin®, GC America Inc., Alsip, IL, USA) for each patient. B. Detail of the bite-block customized.

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  Fig. 2 Gauge pin calibrated-tip of periodontal standardized probe (PCP-UNC15®, Hu-Friedy, Chicago, IL, USA) and radiographic image.

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  Fig. 3 Division of distal aspect of mandibular second molar. A. Occlusal view. B. Distal view. C. Gauge pin inserted in the deepest probing depth. D. Radiographic image obtained with the anatomic reference points. B; bucal aspect of mandibular second molar, L; lingual aspect of mandibular second molar, AR; radiographic apex of distal root of mandibular second molar, NOR; radiographic bone level, LAC; cementoenamel junction.

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  Fig. 4 Drawing (A) and radiographic image (B) prior extraction of the mandibular third molar. Drawing (C) and radiographic image (D) after extraction of the mandibular third molar. AR; radiographic apex of distal root of mandibular second molar, NOR; radiographic bone level, LAC; cementoenamel junction.

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  Fig. 5 A. Radiograph made only with posterior X-ray film positioner. B. Radiograph made with posterior X-ray film positioner adapted to the hollow cylinder. C. Radiograph made with the hollow cylinder adapted to the posterior X-ray film positioner, with a bite-block customized with acrylic resin. D. Radiograph made with the hollow cylinder adapted to the posterior X-ray film positioner, with a bite-block customized and the gauge pin calibrated inserted in the deepest probing deep.

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  Fig. 6 Four examples of periapical radiographic images. A. Initial radiographic image before extraction of the mandibular third molar. B. Final radiographic image after extraction of the mandibular third molar.

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