ASTOL Technique: A Novel Method for Localisation of Impacted Mandibular Tooth

Abstract

Introduction: Object localisation is one of the challenges encountered in diagnosis of impacted teeth, which requires sophisticated two-dimensional and three-dimensional radiographic techniques. These sophisticated radiographs are not readily available in all clinics, and also they carry the risk of increased radiation exposure and increase burden of care. Aim: To evaluate the accuracy of ASTOL (Arvind-Seerab Transmandibular Object Localisation) technique for object localisation in the dried mandible of a cadaver. Materials and Methods: This cross-sectional study was conducted in Chennai city, Tamil Nadu between March 2021 to April 2021. A dried mandible of a cadaver and an extracted premolar was used to simulate 10 cases scenarios of impacted teeth at different regions of the mandible. Two intraoral periapical (IOPA) radiographs were taken for each scenario, from two different projections: first a conventional IOPA of the impacted tooth was taken and second radiograph was taken with the beam projected from the base of the mandible with the sensor placed on the occlusal surface. Both the radiographs taken for each scenario were incorporated into a questionnaire survey and were circulated to 30 dental practitioners. The results were tabulated and represented graphically. Cronbach’s alpha test and Kappa statistics were done to evaluate the internal and interobserver reliability between the validators and respondents respectively. Results: Out of the 30 dental practitioners, a total of 25 responses (14 Males and 11 Females) were received from dental practitioners across the state. The response rate was 83.33% and the mean age of the respondents were 34±5 years. The vertical position of the crown tip of the impacted tooth had a correct response rate of 85.60% (214/250). Angulation of the impacted tooth had a correct response rate of 75.20% (188/250). Mesiodistal positioning of the crown tip of the impacted tooth had a correct response rate of 78% (195/250). Buccolingual positioning of the impacted tooth had a correct response rate of 92.80% (232/250). Conclusion: The ASTOL technique is a novel radiographic technique which can be used as an accurate, reliable and economic alternative to other sophisticated 2D and 3D imaging techniques for object localisation in the mandibular arch.