Near-End of Treatment Panoramic Radiograph in the Assessment of Mesiodistal Root Angulation

Abstract

Abstract Objectives: To test the hypothesis that there is no difference between the actual mesiodistal root angulation and the mesiodistal root angulation as measured on the panoramic radiograph. Materials and Methods: A typodont dentition was set up into a Class I occlusion. Wire struts were placed on the buccal surface of each tooth to represent their long axes. The dentition was fixed into a natural skull for imaging. The radiographic and true mesiodistal angulation of each tooth to a horizontal reference plane (the arch wire) was measured using a coordinate measuring machine (CMM). The mesiodistal root positions were then altered to a more mesial and then more distal position and the measurements were repeated. Results: Only 26.7% of the radiographic root angulations were within the clinically acceptable angular variation range of ±2.5°. The greatest variation in the upper arch occurred in the canine-premolar area where the roots were projected as being more divergent. The greatest variation in the lower arch occurred in the lateral incisor-canine region where these roots were projected as being more convergent. The extent of radiographic distortion is statistically greater in the lower arch than in the upper arch in the ideal (P ≤ .05) and distal (P ≤ .01) root positions. Conclusions: The hypothesis is rejected. There is a clinically significant variation between the radiographic and the true root angulations recorded. Caution is advised when interpreting mesiodistal root angulation using this radiograph.