“RELATIONSHIP BETWEEN IMPACTED MANDIBULAR THIRD MOLAR AND MANDIBULAR CANAL” DOES CONE BEAM COMPUTED TOMOGRAPHY IMAGING PROMISE MORE EFFECTIVE DIAGNOSIS BEFORE EXTRACTION THAN ORTHOPANTAMOGRAPH? - A SYSTEMATIC REVIEW

Abstract

BACKGROUND: Proper diagnosis of impacted mandibular third molars(IMTM)is essentialtoprevent injury at the siteduring extraction and aftermath surgical complications. OPG (Orthopantomograph) is the most common diagnostic aid followed nowadays. However, since the two dimensional imaging does not provide adequate details for diagnosis, CBCT (Cone-Beam Computed Tomography) is preferred in order to avoid such impediments as it provides higher quality imaging and makes the extraction procedure much easier with its ample detailing for diagnosis. AIM: To compare preoperative radiography with cone-beam computed tomography in the assessment of the relationship between impacted mandibular third molar and mandibular canal.METHOD: A systematic review of the records comparing panaromic radiography with cone-beam computed tomography for the preoperative assessment of impacted mandibular third molar and its relationship with the mandibular canal was done. A literature review was performed using Medline, Pubmed, Science direct, and Cochrane. Total of 383 articles appeared from various sources; all articles were screened and 15 were related to the research question. This review was reported according to the PRISMA guidelines. RESULTS: With the 15 articles included in the systematic review as qualitative synthesis, the presence of darkening of roots and interruption of the white line in OPG, as both separate findings and in association with each other are effective in influencing the risk relationship between IMTM and mandibular canal, which further certainly require a 3D evaluation (CBCT) before performing the surgery. CONCLUSON: CBCT imaging provides much a promising evaluation in determining the relationship between impacted mandibular third molars and mandibular canal which is more useful than OPG imaging before the extraction to elude complications both during and after the procedure. KEYWORDS: CBCT, OPG, Extraction, Systematic Review