scholarly journals DISSECTION AND DETAILED ANATOMY OF AN IMPACTED MANDIBULAR THIRD MOLAR. Disección y anatomía detallada de un tercer molar mandibular impactado

2016 ◽  
Vol 5 (3) ◽  
pp. 229-234
Author(s):  
Radu C Ciuluvic? ◽  
Mugurel C Rusu
Keyword(s):  
Surgical Procedures ◽  
Adult Male ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Impacted Tooth ◽  
Mandibular Third Molar ◽  
Mandibular Molar ◽  
Male Cadaver ◽  
Mylohyoid Nerve

Los trastornos neurosensoriales del nervio alveolar inferior (IAN) o el nervio lingual (LN) se reportan comúnmente en casos del tercer molar inferior impactado. Los casos están documentados usualmente mediante estudios imagenológicos. Pruebas de disección de la anatomía detallada en estos casos son raras, sino inexistentes. Se informa aquí sobre un estudio de disección en un caso de un tercer molar inferior impactado (ángulo bucal), en un cadáver de un hombre adulto, 68 años de edad. Más allá de las “clásicas” relaciones del diente impactado con el IAN y el LN, también han sido encontradas estrechas relaciones con las ramas de LN, el ganglio de debajo de la mandíbula, el nervio milohioideo (MN) y la anastomosis del LN y MN. Estos detalles anatómicos deben considerarse también cuando tales casos están documentados en pacientes antes de procedimientos quirúrgicos. Los efectos de los daños del ganglio de debajo de la mandíbula deben ser analizados más.  Neurosensory disturbances of the inferior alveolar nerve (IAN), or the lingual nerve (LN), are commonly reported in cases of third mandibular molar impaction. Cases are usually documented by use of imagistic methods. Dissection proofs of the detailed anatomy in such cases are rare, if not absent. It is reported here a dissection study in a case of an impacted (bucco-angular) third mandibular molar, in an adult male cadaver, 68 years old. Beyond the “classical” relations of the impacted tooth with the IAN and the LN, close relations were also found with the LN branches, submandibular ganglion, mylohyoid nerve (MN), and the anastomosis of the LN and the MN. These anatomical details should be also considered when such cases are documented in patients before surgical procedures. Effects of the submandibular ganglion damage should be further explored.

scholarly journals Comparison of Digital OPG and CBCT in Assessment of Risk Factors Associated with Inferior Nerve Injury during Mandibular Third Molar Surgery

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2282
Author(s):  
Rakhi Issrani ◽  
Namdeo Prabhu ◽  
Mohammed Sghaireen ◽  
Hasna Rasheed Alshubrmi ◽  
Amal Mohamed Alanazi ◽  
...  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Third Molars ◽  
Factors Associated ◽  
Impacted Third Molar ◽  
Mandibular Third Molar ◽  
Mandibular Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background: Pre-operative radiographic assessment of the anatomical relationship between the roots of the mandibular third molar and the inferior alveolar nerve (IAN) is a must to minimize the risk of IAN injury during surgery. Objectives: To compare the radiographic signs of digital orthopantomogram (OPG) and cone-beam computed tomography (CBCT). An additional objective was to assess the cortex status between the mandibular canal and third molar on CBCT images in relation to the demographic characteristics, region (right or left side), and angulation of mandibular molar. Methodology: In this retrospective study, a total of 350 impacted mandibular third molars with a close relationship between the inferior alveolar canal (IAC) and impacted mandibular third molars on digital OPG were further referred for CBCT imaging for assessment of the position of the mandibular canal. The study was conducted between August 2018 and February 2020. Digital OPGs were evaluated for radiographic signs like interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. The age and sex of patients, site of impacted third molar, Winter’s classification of mandibular third molar, position of IAC relative to impacted molar, and the radiographic markers of OPG were assessed for cortical integrity using CBCT. Chi square testing was applied to study the values of difference and binomial logistic regression was done to assess the factors associated with cortication. Statistical significance was set at p ≤ 0.05. Results: Among 350 patients, 207 (59.1%) were male and 143 (40.9%) were female with a mean age of 36.8 years. The most common OPG sign was interruption of white line, seen in 179 (51.1%) cases. In total, 246 cases (70.3%) showed an absence of canal cortication between the mandibular canal and the impacted third molar on CBCT images. Cortication was observed in all cases with a combination of panoramic signs which was statistically significant (p = 0.047). Cortication was observed in 85 (50.6%) cases where IAC was positioned on the buccal side, 11 (16.9%) in cases of inferiorly positioned IAC, and just 8 (7.6%) for cases of lingually positioned IAC which was statistically significant (p = 0.003). Statistically insignificant (p > 0.05) results were noted for cortex status in CBCT images with regards to the age, sex, site, and angulation of impacted third molars. Conclusion: CBCT imaging is highly recommended for those cases where diversion of the mandibular canal is observed on OPG and when the roots are present between canals.

Lingual nerve neuropathy: more than just third molar surgery and inferior alveolar nerve blocks

Dental Update ◽  
2019 ◽  
Vol 46 (8) ◽  
pp. 775-789
Author(s):  
Wei Cheong Ngeow ◽  
Wen Lin Chai
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Third Molar Surgery ◽  
Anatomical Location ◽  
Nerve Blocks ◽  
Dental Procedures ◽  
Mandibular Third Molar ◽  
Dental Practitioners ◽  
Mandibular Third Molar Surgery

Neuropathy of the lingual nerve, when it occurs, often results from third molar surgery, or the provision of inferior alveolar nerve blocks. Investigators have reported that the anatomical location and the unpredictable course of the lingual nerve play important roles in it being affected by these procedures. However, there are many other causes of neuropathy with which most medical and dental practitioners are unfamiliar. This article briefly reviews the course of the lingual nerve, and summarizes the causes and reports of all uncommon aetiologies of neuropathy that can occur along the path of a lingual nerve. The clinical implication and management of lingual nerve neuropathy is discussed. CPD/Clinical Relevance: The reader should appreciate the importance of accurately diagnosing lingual nerve neuropathy as it can manifest from many other dental procedures and non-dental causes, apart from routine mandibular third molar surgery and local anaesthetic injections.

scholarly journals Variant root morphology of third mandibular molar in normal and impacted teeth

2017 ◽  
Vol 6 (3) ◽  
pp. 1052-1061
Author(s):  
Isaac Kipyator Bokindo ◽  
Fawzia Butt ◽  
Francis Macigo
Keyword(s):  
Root Morphology ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Impacted Teeth ◽  
The Third ◽  
Mandibular Third Molar ◽  
Mandibular Molar ◽  
Panoramic Views

The mandibular third molar poses a challenge to dental surgeons due to it’s unpredictable morphology which leads to increased difficulty during its extraction. The root morphology of the third molar is considered to be the most variable in the human dentition. The study aims to document these variations which will be useful while undertaking procedures on the third molar. Three hundred and fifty nine panoramic views of the mandible were obtained from the Radiology division for patients seeking treatment in the School of Dental Sciences since 2010. The prevalence of third molar impaction was found to be 27%, with mesioangular being the commonest at 21.9% using the Winter’s classification. Dilacerations of roots was recorded at 44%, with a ratio of normal to dilacerated of 1:1 seen in impacted teeth while, non impacted teeth had a ratio of 1.3:1. Most teeth had 2 roots (85.5%), with one root seen in 12.1%. Partially fused roots was also observed in 2.4% of cases with only one case showing three roots. The total mean distance from the tips of roots to the mandibular canal was -0.5mm. Higher negative means of -1.5mm was recorded in impacted teeth than in normal teeth (-0.2mm). Teeth with dilacerated roots also showed closer proximity to mandibular canal than straight rooted teeth. The left side of the jaw also showed higher negative means. Present findings suggest that careful considerations should be made on impacted teeth. In addition to the type of impaction, proximity to the inferior alveolar nerve (IAN), number of roots and shape of the roots should be assessed. Similar considerations should also be made to non impacted teeth due to the high unpredictability observed in root morphology.Keywords: Third molar, root morphology, impaction

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 Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Itaru Tojyo ◽  
Takashi Nakanishi ◽  
Yukari Shintani ◽  
Kenjiro Okamoto ◽  
Yukihiro Hiraishi ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Third Molar ◽  
Lingual Nerve ◽  
Control Group ◽  
Nerve Injuries ◽  
Control Groups ◽  
Injury Group ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Lingual Nerve Injuries

Abstract Background Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve

2016 ◽  
Vol 44 (5) ◽  
pp. 616-621 ◽  
Author(s):  
A.J. Kouwenberg ◽  
L.P.P. Stroy ◽  
E.d.Vree- v.d. Rijt ◽  
G. Mensink ◽  
P.J.J. Gooris
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Third Molar
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