scholarly journals The correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molars

2017 ◽  
Vol 49 (2) ◽  
pp. 59
Author(s):  
David Buntoro Kamadjaja ◽  
Djodi Asmara ◽  
Gita Khairana
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Chi Square ◽  
Cross Sectional ◽  
Radiographic Features ◽  
Close Relationship

Background: Odontectomy of lower third molar has a potential risk for inferior alveolar nerve impairment. Paresthesia of inferior alveolar nerve has often been associated with close relationship between the apex of lower third molar and mandibular canal. Rood and Shehab’s category has been commonly used for radiological prediction of inferior alveolar nerve injury following third molar surgery. Purpose: This study aimed to determine whether there was correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molar. Method: This was a retrospective cross-sectional study, using data obtained from the dental record of patients who had undergone odontectomy of lower third molars in Dental hospital of Universitas Airlangga during 2 years period. Samples were cases that, from presurgical radiograph, showed close relationship between lower third molar roots and mandibular canal. The case and non-case groups were assigned based on the presence of paraesthesia and non-paraesthesia of inferior alveolar nerves, respectively. Based on Rood and Shehab’s category, the samples collected were then classified into two groups which were those whose relationship matched and did not match with the category, respectively. Data were analyzed using Chi-square correlation test. Result: Of 975 odontectomy cases included in this study, 80 cases were taken as study samples consisting of 15 and 65 cases assigned, respectively, as case and non-case. The 32 cases matched with the criteria of Rood and Shehab's category while the remainder of 48 cases did not. Of 32 cases which met the criteria of Rood and Shehab’s relationship, only 5 cases showed paraesthesia, whereas out of 48 cases which did not met the criteria 10 cases showed paraesthesia. Statistical analysis showed significance value of 0.770 (p>0.05) indicating that there was no significant correlation between relations of third molar root and mandibular canal, based on Rood and Shehab’s category, and the incidence of inferior alveolar nerve paraesthesia. Conclusion: There was no correlation between Rood and Shehab’s radiographic features and the incidence of paraesthesia of inferior alveolar nerve following odontectomy of lower third molars.

scholarly journals Assessment of role of mandibular third molar in lower anterior crowding among orthodontic patients of Kathmandu Nepal

2020 ◽  
Vol 10 (3) ◽  
pp. 21-26
Author(s):  
Bashu Dev Pant ◽  
Anjana Rajbhandari ◽  
Resina Pradhan ◽  
Manju Bajracharya ◽  
Surendra Maharjan ◽  
...  
Keyword(s):  
Third Molar ◽  
Cross Sectional Study ◽  
Third Molars ◽  
Chi Square ◽  
Cross Sectional ◽  
Anterior Crowding ◽  
Mandibular Third Molar ◽  
Significant Difference ◽  
Orthodontic Patients

Introduction: Crowding in mandibular arch increases with increasing age and etiology of crowding is multifactorial in nature. Role of mandibular third molar in lower anterior crowding remains a topic of controvery over a period of century. The objective of this study was to assess whether there is any correlation between presence of mandibular third molar position and lower anterior crowding. Materials and Method: On the basis of third molar position one hundred and six sample of pretreatment orthodontic patients aged between 17 to 38 years were divided into erupted, erupting and agenesis group. The study was conducted in Peoples Dental College and Hospital from January 2020 to March 2020 after obtaining ethical approval from the institutional review committee. This cross-sectional study was done on dental casts and orthopantomogram; brass wire was used for measuring arch length and digital vernier caliper for measuring tooth material with modified segmental arch analysis method. Result: Among 106 samples collected 55 (51.88%) were female and 51(48.11%) were male and the mean age was 21.53 ± 3.91 years, Chi square and ANOVA test was used for Statistical analysis. This study showed no statistically significant differences between third molar position and lower anterior crowding on right (P= 0.68) and left side (P = 0.45). The study also showed that association between the third molar position and lower anterior crowding is more on left side compared to right side. Conclusion: Mandibular third molars have not statistically significant difference in lower anterior crowding so, extraction of third molars for relieving the anterior crowding is not justifiable

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 Evaluating the Presence of Paresthesia in Patients with Juxta-apical Radiolucency after Third Molar Surgery: A Case-control Study

2021 ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Chi Square ◽  
Exact Test ◽  
Increased Risk

Abstract Background: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with paresthesia in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.Methods: Of an initial sample of 545 mandibular third molars, a total of 75 JAR and 75 control teeth were evaluated by CBCT. The association of JAR with the IAN, position to IAN, lingual cortical plate thinning, and tooth angulation was investigated in this study. Temporary and permanent paresthesia were also examined in the subjects. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis.Results: A significant relationship was found between JAR and temporary paresthesia (P=0.034). However, there was no case of permanent paresthesia. JAR showed no significant relationship with the tooth angulation, cortical plate thinning, position to IAN and proximity to the mandibular canal. The lingual position of JAR relative to the mandibular canal was related to the presence of paresthesia in the JAR group. Also, most cases of paresthesia showed some degree of lingual cortical plate thinning (P=0.012). Conclusion: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary paresthesia. The present findings may indicate the increased risk of nerve injury during the surgical removal of third molars.

scholarly journals Anatomical Position of Lower Third Molar in Relation to Mandibular Canal on Cone-Beam Computed Tomography Images in A Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Bikash Chaudhary ◽  
Ujjwal Joshi ◽  
Pranaya Khanal ◽  
Alok Sagtani ◽  
Sirjana Dahal ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Third Molars ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Introduction: 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. Methods: 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 patients’ mandibular third molars were used. A convenient sampling method was used. Data were analyzed using Statistical package for the Social Sciences. Results: 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. Conclusions: 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.

scholarly journals Panoramic Radiographic Analysis of Signs of Proximity to the Third Molar Roots of the Mandibular Canal in Yemen

2020 ◽  
Keyword(s):  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Third Molars ◽  
Cross Sectional ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
Female Patients ◽  
The Third ◽  
Dental Clinics

Objectives: The objectives of this study were to assess the relationship between the third molar and the mandibular canal, to identify the radiographic markers most prevalent in predicting connectivity between these structures, and to associate these signs and proximity with the position of the third molar according to Bell, Gregory’s and Winter’s classifications. Subjects and methods: A retrospective cross-sectional study was conducted in the city of Sana’a on a sample of Yemeni patients in Ammar Dental Clinics who underwent panoramic radiography in the year 2019 until September 2020. The study consisted of panoramic radiographs of 597 patients with third molars with a total of 1017 third molars; the number of males was 216 (36.2%) and 381 females (63.8%). The panoramic radiographs were evaluated for proximity signs. Inclusion criteria were patients of both sexes who had at least a fully formed third molar of the mandible that was adjacent to the second molar. The radiographs were excluded if evidence of cystic, neoplastic, or extensive caries processes was detected. Seven radiological signs were used to determine if there was contact between the third molar and the mandibular canal. Results: A proximity to the mandibular canal was verified for 620 (61%) of 1017 third molars. The most frequent radiographic signs of proximity were darkened roots (315 teeth [31%]) and discontinuity of the mandibular canal (267 teeth [26.3%]). Third molar/mandibular canal proximity was found significantly more frequently in female patients and in patients aged 24 years and younger (P < 0.001). The tooth positions most frequently associated with proximity between the third molar and the mandibular canal were position C (highest point of the third molar located at or below the cervical margin of the second molar) and the mesioangular position (long axis of the third molar angled mesially toward the second molar). Conclusions: The frequency of third molar/ mandibular canal proximity was greater in female patients and patients aged 24 years or younger. The most frequently observed signs of proximity were darkening of the roots and discontinuity of the mandibular canal. The tooth positions most frequently associated with proximity of the third molar to the mandibular canal were position C and the mesioangular position.

scholarly journals Evaluation of Juxta-Apical Radiolucency as a Risk Factor for Inferior Alveolar Nerve Damage: A Cone-Beam Computed Tomography (CBCT) Study

2020 ◽  
Vol 21 (10) ◽  
Author(s):  
Leila Khojastepour ◽  
Mohammad Ghasemi ◽  
Shabnam Rasti ◽  
Mahvash Hasani
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Cross Sectional ◽  
The Relationship

Background: Injuries to the lingual and inferior alveolar nerves (IAN) through third molar surgery are common and complicated clinical problems. Juxta-apical radiolucency (JAR) is one of the new radiographic signs, suggestive of IAN damage. Objectives: This study aimed to assess the relationship between JAR and IAN and to determine its effects on the cortical plate. Methods: In this cross-sectional study, after evaluating an initial sample of 450 cases, the cone-beam computed tomography (CBCT) images of 20 patients with JAR were compared with those of 20 age-matched patients without JAR in the axial and multi-planar images. The relationship between JAR and IAN was evaluated, and thinning of the mandibular cortical plates was also investigated. Statistical analysis was performed using descriptive tests and chi-square test in SPSS version 23. Results: The relationship between JAR and IAN was statistically significant (P = 0.001). The cortical plates were perforated in 75% of cases with JAR as opposed to 45% of cases without JAR (P = 0.06). The relationship between the location of JAR and IAN was also significant (P = 0.004). Conclusions: Based on the present results, JAR was associated with IAN in most cases. Thinning of the cortical plates was observed in all cases of JAR.

scholarly journals Hard Tissue Preservation in Minimally Invasive Mandibular Third Molar Surgery Using In Situ Hardening TCP Bone Filler

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Wilfried Engelke ◽  
Marcio Lazzarini ◽  
Víctor Beltrán
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Case Series ◽  
Third Molar Surgery ◽  
Hard Tissue ◽  
Socket Preservation ◽  
Bone Filler ◽  
Close Relationship ◽  
Bone Height

Background. Maintenance of hard tissue in the case of impacted third molars (M3M) with close relationship to the mandibular canal is still a surgical challenge which may be overcome using the inward fragmentation technique. Methods. A consecutive case series of 12 patients required the extraction of 13 impacted M3M with a close relationship to the inferior alveolar nerve (IAN). Via occlusal miniflaps, M3M were exposed occlusal under endoscopic vision and removed by inward fragmentation. All patients received socket preservation with resorbable in situ hardening TCP particles to reduce the risk of pocket formation at the second molar. Results. All 13 sites healed uneventfully. Bone height was assessed using CBCT cross-sectional reformats pre- and 3 months postoperatively. The bone height was reduced by 1.54 mm lingual (SD 0.88), 2.91 mm central (SD 0.93), and 2.08 mm buccal (SD 1.09). Differences were significant at a 0.05% level. No tissue invagination at the extraction sites was observed. Conclusions. Major bone defects can be avoided safely using inward fragmentation surgery. The self-hardening bone filler appears to enhance the mineralization of the intrabony defect.

scholarly journals The elusive retromolar foramen and retromolar canal: A CBCT study

2021 ◽  
Vol 7 (3) ◽  
pp. 118-124
Author(s):  
Vijeta Pannalal ◽  
Abhijeet Deoghare ◽  
Chinar Fating ◽  
Satyendra Jha
Keyword(s):  
Single Case ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Subjective Assessment ◽  
Mandibular Canal ◽  
Chi Square ◽  
Retromolar Foramen ◽  
Chi Square Test ◽  
Observational Descriptive Study ◽  
Retromolar Canal

This study aims to evaluate the presence of retromolar foramen (RMF) and retromolar canal (RMC) in the mandible using cone beam computed tomography (CBCT) in Chhattishgarh population and to correlate its possible clinical impact. 175 CBCT images were collected from which 100 bilateral CBCT images of patients were retrospectively selected from the Department of Oral Medicine and Radiology of the Chhattishgarh Dental College and Research Institute and evaluated bilaterally which were taken for diagnostic purposes from maxillofacial radiology clinic and data were statistically analyzed. This was an observational descriptive study and all the images were processed and analyzed on CS3D imaging software. The data was analyzed using chi square test. The prevalence of RMF and RMC was observed in 8.5%, of which 10 were in females and 7 in males. The RMCs traversed in different directions – horizontal, vertical and angular. Based on the subjective assessment, each of these canals was further subclassified into straight and curved canal. In the present study in 12 of the cases angular curved type was found and in 3 cases, vertical straight was noticed. The bifurcation of the inferior alveolar nerve (IAN) canal was observed in 15% of the scans and remaining 85% had single mandibular canal. The proximity of RMF from buccal and lingual cortical plates was found buccally in 16 cases and in single case was found to be lingually. Position of RMF might change with the presence and absence of third molar. The absence of third molar results in anteriorly located RMF. In majority of cases it was found that RMF was located more buccal than lingual. The parameters considered in the current study will guide the oral and maxillofacial surgeons while giving incisions in 3molar impacted cases, other pathologies and ease to preserve the retromolar foramen.

scholarly journals Correlation Between the Maturation Stages of Mandibular Third Molars and Chronological Age in Patients Visiting Sardar Begum Dental College, Peshawar

2019 ◽  
Vol 5 (2) ◽  
pp. 3-7
Author(s):  
Muhammad Ilyas ◽  
Asma Khan ◽  
Syed Murad Ali Shah ◽  
Salman Khan ◽  
Junaid Nadeem Malik
Keyword(s):  
Pearson Correlation ◽  
Third Molar ◽  
Cross Sectional Study ◽  
Chronological Age ◽  
P Value ◽  
Third Molars ◽  
Cross Sectional ◽  
Mandibular Third Molar ◽  
Maturation Stages ◽  
Mandibular Third Molars

OBJECTIVES: The objective of this study was to determine the correlation of chronological age with the maturation stages of mandibular third molar. METHODOLOGY: This descriptive, cross-sectional study was conducted at Sardar Begum Dental College, Gandhara University Peshawar on 384 patients from January 2018 to June 2018 and included patients having age 11-26 years with good quality Orthopantomogram showing mandibular third molar tooth germs bilaterally. Data were analyzed using SPSS version 22. p ≤ 0.05 was considered as statistically significant. RESULTS: Females 286 (74.5%) were predominant than males 98 (25.5%) with mean age presentation of 18.12±3.03 years. The most frequent stage of Demirjian’s stages of mandibular third molar was stage F (24.7%). Pearson correlation showed that maturation stages of mandibular third molars were significantly related to the chronological age ( r=0.446, p value=0.00). CONCLUSION: A correlation between maturation stages of mandibular third molars and chronological age existed.

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.

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