Do anatomical variations of the mandibular canal pose an increased risk of inferior alveolar nerve injury after third molar removal?

2021 ◽  
Author(s):  
Myrthel Vranckx ◽  
Hannah Geerinckx ◽  
Hugo Gaêta-Araujo ◽  
Andre Ferreira Leite ◽  
Constantinus Politis ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Increased Risk ◽  
Inferior Alveolar Nerve Injury

scholarly journals Frequency and risk factors for injury of the inferior alveolar nerve during surgical extraction of the impacted lower third molars

2019 ◽  
Vol 76 (12) ◽  
pp. 1240-1244
Author(s):  
Dejan Dubovina ◽  
Stevo Matijevic ◽  
Filip Djordjevic ◽  
Jelena Stanisic ◽  
Branko Mihailovic ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Statistical Significance ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Sensory Disturbance ◽  
Third Molars ◽  
Root Tips ◽  
Surgical Extraction ◽  
Inferior Alveolar Nerve Injury

Background/Aim. The injury of inferior alveolar nerve during a surgical extraction of impacted lower third molars, followed by sensory disturbance, is, for the patient, an extremely unpleasant complication. The aim of this study was to determine the frequency of this complication after the third molar surgery and its frequency depending on a tooth position and tooth relation to the mandibular canal. Methods. In this study, 800 surgical extractions of the impacted lower third molar were performed. The position of the impacted tooth was recorded according to the Winter classification, as well as the ratio of their root tips to the mandibular canal using the Tanaka et al. and Rood and Shebab classifications. Results. The frequency of the recorded post extraction sensory disturbance was 2.25%, most frequently when teeth were in the mesioangular position. Concerning Tanaka and al. classification, the incidence of injuries was inversely proportional to the increase of distance between roots and mandibular canal with the statistical significance in cases where mandibular canal overlaps more than a half of the root of the tooth (p = 0.001). Considering the radiological signs recommended by Rood and Shehab, a higher frequency of the inferior alveolar nerve injury was recorded when illumination in the area of the root tips was present and when the loss of linear overshadowing characterized by the ?roof? and the ?bottom? of the mandibular canal were observed, or diversion of the canal and root deflection, but without a statistical significance. Conclusion. The superposition of the mandibular canal with the lower third molar roots at the panoramic radiographies may increase a possibility of the inferior alveolar nerve injury. The angulations of the impacted lower third molar as well as the vicinity of the tips of its roots to the content of the mandibular canal, do not significantly affect the frequency of the nerve injury.

Inferior alveolar nerve injury related to surgery for an erupted third molar

2007 ◽  
Vol 103 (2) ◽  
pp. e7-e9 ◽  
Author(s):  
Andrea Savi ◽  
Maddalena Manfredi ◽  
Silvia Pizzi ◽  
Paolo Vescovi ◽  
Silvano Ferrari
Keyword(s):  
Nerve Injury ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Inferior Alveolar Nerve Injury

scholarly journals Predicting the Risk of Inferior Alveolar Nerve Injury in Impacted Lower Third Molars Using Panoramic Radiography and Cone Beam Computed Tomography

2021 ◽  
Vol 10 (34) ◽  
pp. 2910-2914
Author(s):  
Abhishek Verma ◽  
Stuti Verma ◽  
Anushikha Dhankhar ◽  
Nitin Kumar Moral ◽  
Nidhi Nagar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Nerve Injury ◽  
Cone Beam Computed Tomography ◽  
Panoramic Radiography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Cone Beam ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
Inferior Alveolar Nerve Injury

BACKGROUND A serious complication of surgical removal of impacted lower third molars is inferior alveolar nerve (IAN) injury. Evaluation of radiographic factors to predict IAN injury using CT and panoramic radiography includes root morphology assessment, follicular sac size, mandibular bone density, inferior alveolar nerve and vessels, condition of the overlying tissues, relation of the impacted tooth with the body and ramus of the mandible and the adjacent teeth. This study was done to evaluate the radiological features of the impacted lower mandibular teeth and their relationship with IAN through panoramic radiography and CT and to assess the most predictable radiological criteria for inferior alveolar nerve injury in impacted third molar surgery. METHODS All the patients indicated for lower third molar extraction were included in the study and pre-operative conventional panoramic radiographs (Planmeca Proline PM 2002 CC, Helsinki, Finland) and CBCT (Kodak CBCT) were taken. Any post-operative nerve injuries detected were followed up after 15 days or 1 month. Fisher’s exact test was done to find the association between the outcome variable and explanatory variables. RESULTS Only 11.4 % (N = 4) of all participants had IAN injury following surgical disimpaction. All the participants with IAN injury showed narrowing of the canal on their preoperative panoramic radiographs and presence of nerve approximation with the tooth in cone beam computed tomography (CBCT) reports (P < 0.05). CONCLUSIONS A statistically significant association exists between IAN injury and nerve exposure, radiographic signs of nerve involvement for panoramic radiograph, level of third molar impaction, and nerve approximation in CBCT. KEY WORDS Inferior Alveolar Nerve Injury, Lower Third Molar Impaction, Panoramic Radiography, CBCT

scholarly journals Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

2015 ◽  
Vol 11 (3) ◽  
pp. 1-5
Author(s):  
Alok Sagtani ◽  
Reshu Agrawal Sagtani ◽  
Mehul Jaisani ◽  
Leeza Pradhan
Keyword(s):  
Nerve Injury ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Viable Alternative ◽  
Third Molars ◽  
Dry Socket ◽  
Root Exposure ◽  
Mandibular Third Molars ◽  
Inferior Alveolar Nerve Injury

Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN) injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7%) showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3):1-5.

Coronectomy vs. Total Removal for Third Molar Extraction

2012 ◽  
Vol 91 (7) ◽  
pp. 659-665 ◽  
Author(s):  
H. Long ◽  
Y. Zhou ◽  
L. Liao ◽  
U. Pyakurel ◽  
Y. Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Nerve Injury ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
High Rate ◽  
Total Removal ◽  
Randomized Controlled ◽  
Third Molar Extraction ◽  
Root Exposure ◽  
Inferior Alveolar Nerve Injury

The objective of this systematic review was to compare the outcomes between coronectomy and total removal for third molar extractions with high risk of nerve injury and to help practitioners make prudent decisions on whether and how third molars should be removed. PubMed, Embase, Web of Science, CENTRAL, and SIGLE were searched from January 1990 to October 2011 for randomized or non-randomized controlled trials. Four studies met our inclusion criteria. The pooled risk ratio (coronectomy vs. total removal) was 0.11 (95% CI = 0.03-0.36), 1.03 (95% CI = 0.54-1.98), 0.55 (95% CI = 0.28-1.05), and 1.14 (95% CI = 0.57-2.30) for inferior alveolar nerve injury, post-operative infection, dry socket, and pain at 1 wk after surgery, respectively. A relatively high rate of failed coronectomy in one study (38.3%, compared with 2.3%-9.4% in others) may be attributed to a higher proportion of narrowing roots and vertical impactions. Although root migration rate was high (13.2%-85.29%), the migration distances were short (3.06 ± 1.67 mm), and the directions were away from the nerves. Moreover, the rates of re-operation and root exposure were low. Therefore, coronectomy appears superior to total removal for reducing inferior alveolar nerve damage and could be used in clinical practice for third molar extractions with high risk of nerve injury.

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