Abstract
Background:The relationship between impacted mandibular third molar and mandibular canal is important for removal of this tooth. Panoramic radiography is one of the commonly used diagnostic tools for evaluating the relationship of these two structures.Objectives:To evaluate the accuracy of panoramic radiographic findings in predicting direct contact between mandibular canal and impacted third molars on 3D digital images, and to define panoramic criterion in predicting direct contact between the two structures.Methods:Two observers examined panoramic radiographs of 178 patients (256 impacted mandibular third molars). Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root, diversion of mandibular canal and narrowing of third molar root were evaluated for 3D digital radiography. Direct contact between mandibular canal and impacted third molars on 3D digital images was then correlated with panoramic findings. Panoramic criterion was also defined in predicting direct contact between the two structures.Results:Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root were statistically significantly correlated with direct contact between mandibular canal and impacted third molars on 3D digital images (p < 0.005), and were defined as panoramic criteria in predicting direct contact between the two structures.Conclusion:Interruption of mandibular canal wall, isolated or with darkening of third molar root observed on panoramic radiographs were effective in predicting direct contact between mandibular canal and impacted third molars on 3D digital images. Panoramic radiography is one of the efficient diagnostic tools for pre-operative assessment of impacted mandibular third molars.
Highlights
Removal of impacted mandibular third molar is one of the routine operations in oral and maxillofacial surgery [1]
There were reports [6, 7, 9, 11] that showed the following 4 panoramic features were significantly associated with inferior alveolar nerve exposure following third molar extraction: interruption of mandibular canal, darkening of third molar root, diversion of mandibular canal and narrowing of third molar root
Many studies reported that the interruption of mandibular canal was the most found panoramic feature that associated with direct contact between the two structures, which could be the risk of nerve injury and paraesthesia [2, 6, 8, 12]
Summary
Removal of impacted mandibular third molar is one of the routine operations in oral and maxillofacial surgery [1]. The Open Dentistry Journal, 2016, Volume 10 323 one of the most serious consequences Postoperative complications such as swelling, trismus and pain are not difficult to manage, but the functional loss of sensory innervations of the lower lip may cause traumatic injuries and fibromas, scar tissue, and mucocele formation on the mucosa [2]. Panoramic radiographs are imaging modality most commonly used by oral and maxillofacial surgeons to view impacted third molars and to estimate the risk of inferior alveolar nerve injuries [5 - 9]. Many studies reported that the interruption of mandibular canal was the most found panoramic feature that associated with direct contact between the two structures, which could be the risk of nerve injury and paraesthesia [2, 6, 8, 12]. Panoramic radiography is one of the commonly used diagnostic tools for evaluating the relationship of these two structures
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