Comparison of CBCT and panoramic radiography for the assessment of bone loss and root resorption on the second molar associated with third molar impaction: a systematic review.

Objective: To investigate whether the use of cone beam CT (CBCT) changes the diagnosis of external root resorption (ERR) or marginal bone loss (MBL) involving a second molar adjacent to an impacted third molar.

Methods: A systematic search was applied in PubMed, EMBASE, Scopus, Web of Science, LILACS, Google Scholar, OpenGrey, and ProQuest. Studies assessing the detection of ERR or MBL in a second molar adjacent to an impacted third molar through CBCT and panoramic radiography (PAN) were included. Prevalence and agreement between PAN and CBCT on the detection of ERR and MBL were collected. The risk of bias was assessed using the MAStARI.

Results: A total of 593 papers were identified, and after a 2-phase selection, 5 studies were included in the narrative synthesis. Regarding ERR, its prevalence in PAN was reported from 5.31 to 19.5% and from 22.8 to 62.0% in CBCT. The percentage of agreement varied from 28.5 to 74.0%. The prevalence of MBL varied from 21.9 to 62.9% in PAN, while those values varied from 21.6 to 80% in CBCT images. The percentage of agreement between PAN and CBCT for the detection of MBL ranged from 66.0 to 85.0%. Four studies presented low risk of bias and one had moderate risk.

Conclusions: More ERR and MBL are assessed in CBCT compared to PAN. There is a considerable agreement between PAN and CBCT assessment of ERR and MBL, however, mostly related to the absence of the pathology rather its presence.