Analysis of the anatomical relationship between the roots of three lower molars with the lingual bone plate and the mandibular canal using cone beam computed tomography

Abstract

Odontectomy of the inferior wisdom teeth is considered to be one of the most frequently performed dental surgeries. It is certain that in order to prevent possible complications, the oral surgeon must have extensive knowledge regarding the anatomy of the region, possible intra– and postoperative risks, as well as treatment methods that would minimize the occurrence of complications. Of course, a key aspect in choosing the treatment technique and method is represented by the paraclinical investigations, and currently CBCT is considered to be the “golden” standard in visualizing the relationship of the third inferior molars to the neighboring anatomical structures, a fact that significantly contributes to the optimization the provision of dental surgical assistance. The purpose of this study was to reveal the role of the CBCT paraclinical radiological examination in the pre–surgical evaluation of the anatomical relationships of the roots of the lower third molars with the neighboring anatomical elements for the prophylaxis of postextractional complications. Material and methods. The prospective clinical study was based on the visualization of tomographic sections of 116 CBCTs, with a total of 160 inferior wisdom teeth, analyzing various study variables such as the relationship of the inferior wisdom teeth roots to the mandibular canal, to the lingual bony plate, root morphology, etc., with their subsequent statistical analysis. Results and discussion. The extraction of the lower wisdom teeth can be associated with the occurrence of various complications such as the association of postoperative infection, dislodging the teeth into the neighboring spaces, nerve damage. It is important to use preoperatively both the predictability scale of the difficulty of extraction of inferior third molar and the three–dimensional paraclinical investigations in order to plan a treatment plan involving low risks of intra– and postoperative complications. Conclusions. The use of three–dimensional paraclinical investigations such as CBCT are absolutely necessary both for visualizing the relationship between anatomical structures and for planning complex clinical cases.