Journal of Oral Health and Oral Epidemiology

Journal of Oral Health and Oral Epidemiology

Quantitative assessment of the relationship of mandibular canal with impacted third molars: A retrospective analysis of cone beam computed tomographic evaluation in Dharwad population, India

Document Type : Original Article

Authors
Kruthika Satyabodh S Guttal 1
Shantala Arun Kumar 2
Krishna Burde 1
1 Professor, Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Sattur, Dharwad, India
2 Assistant Professor, Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Sattur, Dharwad, India
10.22122/johoe.v10i4.1179
Abstract
BACKGROUND AND AIM: Impacted third molars tend to pose certain problems varying from pain, repeated pericoronitis, bone loss with adjacent teeth, etc. The surgical removal of impacted teeth requires appropriate planning to avoid complications. Cone beam computed tomography (CBCT) is an important radiographic tool that facilitates appropriate treatment planning. This retrospective analysis of the existing orthopantomographs (OPG) and CBCT images of third molars was conducted to assess the topographic relationship between impacted mandibular third molar and the inferior alveolar nerve (IAN) canal.
METHODS: In this study, 124 OPGs and CBCT images were used to assess the type of impactions and evaluate the relationship of impacted teeth with the IAN.
RESULTS: Mesioangular impaction was the most commonly observed type of impaction followed by vertical, horizontal, and distoangular impactions. The most commonly observed relationship was mandibular canal running apically or buccally with respect to the impacted tooth but without being in contact with it.
CONCLUSION: The classification utilizing the topographic relationship of the impacted mandibular third molar with the IAN canal gives a clear position of the IAN to the impacted teeth. The use of digital volume tomography (DVT) for radiographic assessment reveals the relationship in axial, coronal, and sagittal dimensions, which facilitates appropriate treatment planning to avoid post-operative complications.
Keywords
Third Molars
Cone-Beam Computed Tomography
Mandibular Nerve
Subjects
  1. Shahidi S, Zamiri B, Bronoosh P. Comparison of panoramic radiography with cone beam CT in predicting the relationship of the mandibular third molar roots to the alveolar canal. Imaging Sci Dent 2013; 43(2): 105-9.
  2. Juodzbalys G, Daugela P. Mandibular third molar impaction: Review of literature and a proposal of a classification. J Oral Maxillofac Res 2013; 4(2): e1.
  3. Matzen LH, Wenzel A. Efficacy of CBCT for assessment of impacted mandibular third molars: a review - based on a hierarchical model of evidence. Dentomaxillofac Radiol 2015; 44(1): 20140189.
  4. Gu L, Zhu C, Chen K, Liu X, Tang Z. Anatomic study of the position of the mandibular canal and corresponding mandibular third molar on cone-beam computed tomography images. Surg Radiol Anat 2018; 40(6): 609-14.
  5. Matzen LH, Schropp L, Spin-Neto R, Wenzel A. Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124(5): 506-16.
  6. Matzen LH, Schropp L, Spin-Neto R, Wenzel A. Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT. Dentomaxillofac Radiol 2017; 46(1): 20160330.
  7. Wang D, Lin T, Wang Y, Sun C, Yang L, Jiang H, et al. Radiographic features of anatomic relationship between impacted third molar and inferior alveolar canal on coronal CBCT images: risk factors for nerve injury after tooth extraction. Arch Med Sci 2018; 14(3): 532-40.
  8. Shiratori K, Nakamori K, Ueda M, Sonoda T, Dehari H. Assessment of the shape of the inferior alveolar canal as a marker for increased risk of injury to the inferior alveolar nerve at third molar surgery: A prospective study. J Oral Maxillofac Surg 2013; 71(12): 2012-9.
  9. Tachinami H, Tomihara K, Fujiwara K, Nakamori K, Noguchi M. Combined preoperative measurement of three inferior alveolar canal factors using computed tomography predicts the risk of inferior alveolar nerve injury during lower third molar extraction. Int J Oral Maxillofac Surg 2017; 46(11): 1479-83.
  10. Maglione M, Costantinides F, Bazzocchi G. Classification of impacted mandibular third molars on cone-beam CT images. J Clin Exp Dent 2015; 7(2): e224-e231.
  11. Selvi F, Dodson TB, Nattestad A, Robertson K, Tolstunov L. Factors that are associated with injury to the inferior alveolar nerve in high-risk patients after removal of third molars. Br J Oral Maxillofac Surg 2013; 51(8): 868-73.
  12. Quirino de Almeida BR, Bezerra de Melo N, de Macedo B, I, Area Leao Lopes Araujo Arruda MJ, Meira BP. Association between impacted third molars and position of the mandibular canal: A morphological analysis using cone-beam computed tomography. Br J Oral Maxillofac Surg 2018; 56(10): 952-5.
  13. Ge J, Zheng JW, Yang C, Qian WT. Variations in the buccal-lingual alveolar bone thickness of impacted mandibular third molar: our classification and treatment perspectives. Sci Rep 2016; 6: 16375.
  14. Byahatti S. The relationship of the inferior alveolar nerve canal with the roots of impacted mandibular third molars in a group of the South Indian population. Indian J Oral Sci 2015; 6(3): 108-12.
  15. Chaurasia A, Giri S, Patil R. Evaluation of impacted 3rd molars in Indian ethinicity on panoramic radiograph-a cross sectional study. J Oral Med Oral Surg Oral Pathol Oral Radiol 2016; 2(4): 203-9.
  16. Guerrero ME, Nackaerts O, Beinsberger J, Horner K, Schoenaers J, Jacobs R. Inferior alveolar nerve sensory disturbance after impacted mandibular third molar evaluation using cone beam computed tomography and panoramic radiography: A pilot study. J Oral Maxillofac Surg 2012; 70(10): 2264-70.
  17. Xu GZ, Yang C, Fan XD, Yu CQ, Cai XY, Wang Y, et al. Anatomic relationship between impacted third mandibular molar and the mandibular canal as the risk factor of inferior alveolar nerve injury. Br J Oral Maxillofac Surg 2013; 51(8): e215-e219.
  18. Kim JW, Cha IH, Kim SJ, Kim MR. Which risk factors are associated with neurosensory deficits of inferior alveolar nerve after mandibular third molar extraction? J Oral Maxillofac Surg 2012; 70(11): 2508-14.
  19. Ghaeminia H, Gerlach NL, Hoppenreijs TJ, Kicken M, Dings JP, Borstlap WA, et al. Clinical relevance of cone beam computed tomography in mandibular third molar removal: A multicentre, randomised, controlled trial. J Craniomaxillofac Surg 2015; 43(10): 2158-67.
  20. Guerrero ME, Botetano R, Beltran J, Horner K, Jacobs R. Can preoperative imaging help to predict postoperative outcome after wisdom tooth removal? A randomized controlled trial using panoramic radiography versus cone-beam CT. Clin Oral Investig 2014; 18(1): 335-42.
  21. Park W, Choi JW, Kim JY, Kim BC, Kim HJ, Lee SH. Cortical integrity of the inferior alveolar canal as a predictor of paresthesia after third-molar extraction. J Am Dent Assoc 2010; 141(3): 271-8.
  22. Ghaeminia H, Meijer GJ, Soehardi A, Borstlap WA, Mulder J, Vlijmen OJ, et al. The use of cone beam CT for the removal of wisdom teeth changes the surgical approach compared with panoramic radiography: a pilot study. Int J Oral Maxillofac Surg 2011; 40(8): 834-9.
Journal of Oral Health and Oral Epidemiology
Volume 10, Issue 4
Autumn 2021
Pages 225-230

  • Receive Date 02 September 2020
  • Revise Date 30 September 2021
  • Accept Date 16 October 2021