scholarly journals Prediction of nerve damage by comparing periapical radiographic signs of impacted mandibular third molars in close proximity to inferior alveolar nerve with their true tomographic relationship – An observational study

2021 ◽  
Vol 7 (3) ◽  
pp. 125-130
Author(s):  
Srujana Daniella Remulla ◽  
Jyothirmai Koneru ◽  
Sudhakara Reddy ◽  
Ramesh Tatapudi ◽  
Geetanjali Darna ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Descriptive Analysis ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Chi Square ◽  
Computed Tomographic ◽  
Iatrogenic Complications

The purpose of the study was to correlate the accuracy of Roods and Shehab signs in an intraoral periapical radiograph (IOPAR) with Cone-beam computed tomography (CBCT) findings to indicate Cone-beam computed tomography only in high-risk conditions.70 impacted mandibular third molar teeth in 58 patients above 18 years with intraoral periapical radiographs presenting with one or more root and canal signs of Rood and Shehab criteria were included in the study. Winter's classification was recorded, and the patients were exposed to a Cone-beam computed tomographic scan. True canal – tooth relationship was assessed in the sectional images. Pearson Chi-square test was used to correlate periapical radiograph and tomographic findings, and an unpaired t-test was applied for descriptive analysis.Rood and Shehab canal criteria in the periapical radiographs were significantly correlated to direct contact of an impacted lower third molar with the canal (p< 0.05) and loss of cortication of Mandibular canal (p< 0.05) on the cone-beam computed tomography. Cone-beam computed tomography is recommended to assess the periapical radiographs with canal risk markers pre-operatively to help avoid iatrogenic complications.

scholarly journals Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography

2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Cross Sectional ◽  
Mandibular Third Molar ◽  
The Relationship

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.

scholarly journals Inferior alveolar nerve paraesthesia after overfilling into the mandibular canal, confirmed by cone-beam computed tomography: a case report

2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Claudemir de Souza Júnior ◽  
Ricardo Machado ◽  
Renee Ashley Batts ◽  
Lucas da Fonseca Roberti Garcia
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Cone Beam Computed Tomography ◽  
Root Canal ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Filling Material ◽  
Mandibular Molar ◽  
Patient Reported

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling.   Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.

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 Accuracy of cone-beam computed tomography in defining spatial relationships between third molar roots and inferior alveolar nerve

2016 ◽  
Vol 10 (04) ◽  
pp. 454-458 ◽  
Author(s):  
Roberto Pippi ◽  
Marcello Santoro ◽  
Ferdinando D'Ambrosio
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Morphology ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Root Surface ◽  
Cone Beam ◽  
Spatial Relationships ◽  
Third Molars ◽  
The Third

ABSTRACT Objective: Cone-beam computed tomography (CBCT) has been proposed in surgical planning of lower third molar extraction. The aim of the present study was to assess the reliability of CBCT in defining third molar root morphology and its spatial relationships with the inferior alveolar nerve (IAN). Materials and Methods: Intraoperative and radiographic variables of 74 lower third molars were retrospectively analyzed. Intraoperative variables included IAN exposure, number of roots, root morphology of extracted third molars, and presence/absence of IAN impression on the root surface. Radiographic variables included presence/absence of the cortex separating IAN from the third molar roots on CBCT examination, number of roots and root morphology on both orthopantomography (OPG) and CBCT. The statistical association between variables was evaluated using the Fisher's exact test. Results: In all cases of intraoperative IAN exposure, the cortex appeared discontinuous on CBCT images. All cases, in which the cortical bone was continuous on CBCT images, showed no association with nerve exposure. In all cases in which nerve impression was identified on the root surface, the IAN cortex showed interruptions on CBCT images. No nerve impression was identified in any of the cases, in which the cortex appeared continuous on CBCT images. CBCT also highlighted accessory roots and apical anomalies/curvatures, not visible on the OPG. Conclusions: CBCT seems to provide reliable and accurate information about the third molar root morphology and its relationship with the IAN.

scholarly journals Association between imaging and clinical findings in mandibular third molar surgeries

2018 ◽  
Vol 23 (1) ◽  
Author(s):  
Marcelo Bonifácio da Silva Sampieri ◽  
Danilo Da Silva Correa ◽  
Francisca Lívia Parente Viana ◽  
Thaís Sumie Nozu Imada ◽  
Josfran Da Silva Ferreira Filho ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Statistical Significance ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Mandibular Canal ◽  
Clinical Findings ◽  
Cone Beam ◽  
The Third ◽  
Close Relationship

Objective: it is important to evaluate the position andestablish the third molar relationship with the mandibularcanal to minimize the risk of nerve injury and assistin planning the extraction of this tooth. The panoramicradiograph is the standard diagnostic tool for this purpose.However, if it indicates a close relationship betweenthe third molar and the mandibular canal, furtherinvestigation using cone beam computed tomography(CBCT) may be recommended to check the three-dimensionalrelationship between the tooth and the mandibularcanal. Thus, this study aimed to correlate the clinicalfindings (observed in third molar surgeries) to imagingfindings (observed in panoramic radiographs andCBCT). Subjects and method: after the extraction of 20mandibular third molars, the panoramic radiograph andthe cone beam computed tomography were analyzed.Then, the surgical findings were correlated to the imagefindings. Results: It was observed that the radiographicfinding type 2 (darkening of roots) observed in the panoramicradiograph presented a greater relation to theabsence of cortical bone between the mandibular canaland the third molar (CBCT finding), with statistical significance(p

scholarly journals Bifid canals: identification of three clinical cases using cone-beam computed tomography images

2018 ◽  
Vol 66 (3) ◽  
pp. 263-266
Author(s):  
Paulo de Camargo MORAES ◽  
Daniela Prata TACCHELLI ◽  
Rubens Gonçalves TEIXEIRA ◽  
Luciana Butini OLIVEIRA ◽  
José Luiz Cintra JUNQUEIRA
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Bone Lesions ◽  
Computed Tomography Images ◽  
First Case ◽  
Clinical Cases

ABSTRACT Anatomical variations of mandibular canal have rarely been reported in the literature. The aim of this paper is to present three clinical cases of bifid mandibular canal diagnosed with cone-beam computed tomography (CBCT) as well as discuss its clinical implications. The first case is very interesting due to its anatomic variation verified in a panoramic radiograph during orthodontic planning, mimicking an odontogenic tumor. The second and the third cases were identified during tomographic evaluation for third molar exodontia. The diagnosis of bifid canals is extremely relevant in order to avoid complications during surgical procedures and implant placement as well as anesthesia failures which cause pain, paresthesia and bleeding. Furthermore, the shape of these anatomical variations can be confused with bone lesions.

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