Abstract
The positional relationship between the mandibularcanal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury. The purpose of this study wasto classify the anatomical three dimensional relationship between the proximity of impacted mandibular third molars to the inferior alveolar canal. The descriptive cross-sectional study was conducted inthe Department of Oral and Maxillofacial Surgery of a tertiary care hospital from July 2020 to August 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number 2506202001). Cone-beam computed tomography images of 200 patient's mandibular third molars were used. A convenient sampling method was used. Data were analyzed using Statistical package for the Social Sciences. Mandibular canal relative to the roots of the mandibular third molar was observed on the apical side in 104 (52.0%) and 173 (86.5%) third molars had direct contact with the mandibular canal. About 36 (97.3%) lingually placed mandibular third molars had contact with the mandibular canal. The findings of the study conclude that most of the mandibular third molars situated lingually had a higher occurrence of mandibular nerve involvement. The anatomic structures of the mandibular third molar and the mandibular canal may be helpful to draw upon the adequate surgical plan to avoidor reduce nerve involvement.
Highlights
The positional relationship between the mandibular canal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury
Ascertaining the position of impacted third molars and their contiguity with the inferior alveolar canal is of utmost importance before attempting their surgical removal to prevent the complication of an injury to inferior alveolar nerves and vessels
Out of total 200 third molars, the mandibular canal concerning the mandibular third molars root was on the apical side 104 (52.0%) where as none of the third molars were observed between the roots (Table 1)
Summary
The positional relationship between the mandibular canal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury. The purpose of this study was to classify the anatomical three-dimensional relationship between the proximity of impacted mandibular third molars to the inferior alveolar canal. The extraction of mandibular third molars is one of the most common surgical procedures done in the hospital. Ascertaining the position of impacted third molars and their contiguity with the inferior alveolar canal is of utmost importance before attempting their surgical removal to prevent the complication of an injury to inferior alveolar nerves and vessels.. Due to overlapping images on these x-ray films, it is difficult to judge the positional relationship precisely, especially in the buccolingual direction.. With three-dimensional images, a conebeam computed tomography (CBCT) has been widely applied in clinical work. Due to overlapping images on these x-ray films, it is difficult to judge the positional relationship precisely, especially in the buccolingual direction. With three-dimensional images, a conebeam computed tomography (CBCT) has been widely applied in clinical work.
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