scholarly journals Automated Prediction of Extraction Difficulty and Inferior Alveolar Nerve Injury for Mandibular Third Molar Using a Deep Neural Network

2022 ◽  
Vol 12 (1) ◽  
pp. 475
Author(s):  
Junseok Lee ◽  
Jumi Park ◽  
Seong Yong Moon ◽  
Kyoobin Lee
Keyword(s):  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Third Molars ◽  
Radiographic Image ◽  
Common Procedure ◽  
Radiographic Images ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Extraction of mandibular third molars is a common procedure in oral and maxillofacial surgery. There are studies that simultaneously predict the extraction difficulty of mandibular third molar and the complications that may occur. Thus, we propose a method of automatically detecting mandibular third molars in the panoramic radiographic images and predicting the extraction difficulty and likelihood of inferior alveolar nerve (IAN) injury. Our dataset consists of 4903 panoramic radiographic images acquired from various dental hospitals. Seven dentists annotated detection and classification labels. The detection model determines the mandibular third molar in the panoramic radiographic image. The region of interest (ROI) includes the detected mandibular third molar, adjacent teeth, and IAN, which is cropped in the panoramic radiographic image. The classification models use ROI as input to predict the extraction difficulty and likelihood of IAN injury. The achieved detection performance was 99.0% mAP over the intersection of union (IOU) 0.5. In addition, we achieved an 83.5% accuracy for the prediction of extraction difficulty and an 81.1% accuracy for the prediction of the likelihood of IAN injury. We demonstrated that a deep learning method can support the diagnosis for extracting the mandibular third molar.

scholarly journals Inferior alveolar nerve injury assessment after surgical removal of mandibular third molar.

2020 ◽  
Vol 27 (03) ◽  
pp. 530-534
Author(s):  
Abdul Wahid Bhangwar ◽  
Muhammad Irfan Khan ◽  
Hira Fatima ◽  
Salman Shams
Keyword(s):  
Nerve Injury ◽  
Local Anesthesia ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Inferior Alveolar Nerve Injury

To assess the nerve injury (inferior alveolar nerve) after surgical removal of mandibular third molars under local anesthesia. Study Design: Observational study. Setting: Oral & Maxillofacial Surgery Department LUMHS Jamshoro/Hyderabad. Period: From 11th November 2015 to 10th May 2016. Material & Methods: This study consisted of one hundred patients. Inclusion criteria’s were patients with impacted mandibular third molar, patient’s age from 18 to 45years and irrespective of gender. Exclusion criteria were patients younger than 18yrs of age of above 45 years, patients having neurological disorders, medically compromised patients, patients receiving radiotherapy or chemotherapy, patients with known allergy to local anesthesia, patients having pathology due to mandibular third molars, patients radiographicaly root is very near to inferior dental canal. Results: Out of 100 patients incorporated in this research 66 were male (66%) and 34 female (34%). The mean age was 29+3.20 years. Common indication of extraction were recurrent pericoronitis  52(52%) cases followed by deep caries/ pulpitis in 28(28%)  cases, orthodontic reason in 11(11%) cases and caries to adjacent tooth in 9(9%) cases. Third molar impaction according to winter’s classification were Mesioangular in 54(54%) cases followed by Horizontal in 26(26%) cases and Vertical in 11(11%). Radiographic showed Narrowing of root in 21% cases and narrowing of inferior dental (ID) canal 20% cases, followed by diversion of ID canal in 16 % cases, deflection of root 14 % cases and darkening of root in 11% cases. After surgical removal of mandibular third molar, the inferior alveolar nerve injury was observed in 6(6%) cases. Conclusion: We conclude that inferior alveolar nerve paresthesia occurs in 6% after surgical removal of mandibular third molars.

scholarly journals Deep learning based prediction of extraction difficulty for mandibular third molars

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong-Hun Yoo ◽  
Han-Gyeol Yeom ◽  
WooSang Shin ◽  
Jong Pil Yun ◽  
Jong Hyun Lee ◽  
...  
Keyword(s):  
Deep Learning ◽  
Third Molar ◽  
Learning Model ◽  
Classification Model ◽  
Third Molars ◽  
Radiographic Image ◽  
Radiographic Images ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Deep Learning Model

AbstractThis paper proposes a convolutional neural network (CNN)-based deep learning model for predicting the difficulty of extracting a mandibular third molar using a panoramic radiographic image. The applied dataset includes a total of 1053 mandibular third molars from 600 preoperative panoramic radiographic images. The extraction difficulty was evaluated based on the consensus of three human observers using the Pederson difficulty score (PDS). The classification model used a ResNet-34 pretrained on the ImageNet dataset. The correlation between the PDS values determined by the proposed model and those measured by the experts was calculated. The prediction accuracies for C1 (depth), C2 (ramal relationship), and C3 (angulation) were 78.91%, 82.03%, and 90.23%, respectively. The results confirm that the proposed CNN-based deep learning model could be used to predict the difficulty of extracting a mandibular third molar using a panoramic radiographic image.

scholarly journals Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat

2019 ◽  
Vol 8 (2) ◽  
pp. 79-83
Author(s):  
Tariq Sardar ◽  
Gulrukh Sheikh ◽  
Saddique Aslam ◽  
Numan Muhammad Khan ◽  
Javed Akhtar Rana
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Age Group ◽  
Third Molars ◽  
Impacted Tooth ◽  
Female Ratio ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background: The extraction of an impacted mandibular third molar (MTM), with associated pathologies or clinical manifestations is an important and one of the most frequent decisions in dentistry. The angle formed by the longitudinal axis of second and third molar is used to determine angulation of impacted MTM. The aim of this study was to identify the pattern of angulations of impacted mandibular third molar and common indications for extraction associated with these angulations.Material and Methods: This descriptive cross-sectional study was carried out at Department of Oral & Maxillofacial Surgery, Khyber Medical University Institute of Dental Sciences, Kohat, Khyber Pakhtunkhwa (KP) from November 2017 to July 2018. A total of 349 patients presenting with impacted mandibular third molars were included in this study. Name, age, gender, address, the angulation of the impacted tooth and the indication for extraction of the impacted tooth were recorded. Data comprising of qualitative and quantitative variables were analyzed using SPSS version 17.Results: Out of 349 patients, 206 were male and 143 females, with the male to female ratio of 1.4:1. The age range of the patients was from 18 years to 60 years with a mean age of 26 ± 6 years. The most common age group with impacted third molar was ≤ 25 years followed by 26 to 30 years’ age group. The most common angulation was mesioangular followed by vertical, horizontal and distoangular impacted mandibular third molar. Pericoronitis was the most common indication for extraction in all angulations except horizontal impaction where root resorption of the second molar was more common.Conclusion: Mesioangular is the most common angulation in impacted mandibular third molars. Pericoronitis is the main indication for all angulations of impacted mandibular third molars except horizontal angulation, occurring mostly in the third decade of life.

scholarly journals Incidence of neurosensory deficits following surgical removal of mandibular third molars: a prospective clinical study

2019 ◽  
Vol 7 (5) ◽  
pp. 1546
Author(s):  
Thaufiq Ahamed M. I. ◽  
Naveen Jayakumar ◽  
Neelakandan R. S.
Keyword(s):  
Tamil Nadu ◽  
Statistical Significance ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Surgical Removal ◽  
Third Molars ◽  
Post Surgery ◽  
Mandibular Third Molars

Background: The aim of this prospective study was to determine the incidences of inferior alveolar nerve and lingual nerve deficit following surgical removal of impacted mandibular third molars and to evaluate the risk factors responsible for these postoperative neurosensory deficits.Methods: A total of 80 patients who reported to department of oral and maxillofacial surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India requiring surgical removal of impacted mandibular third molar were included in this cross-sectional study. Standard surgical procedure was performed. All patients were reassessed one week post-surgery. Subjectively reported altered sensations were recorded and objective assessments were performed with light touch test, two-point discrimination threshold and pin-pick pain threshold. The collected data was analyzed using the chi square test to find out any clinical relevance.Results: There was no inferior alveolar nerve related neurosensory deficits and 6 (7.5%) resulted in lingual nerve related neurosensory deficits. The incidence of LN deficit for mesioangular, horizontal, distoangular was 1.3%, 3.8% and 2.5% respectively. Type of impaction assumed a mild statistical significance (p = 0.050).Conclusions: This study highlights the importance of careful preoperative clinical and radiographic assessment of patients where third molar surgery is planned. The surgical technique of third molar removal is also likely to have great impact on the outcome.

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.

scholarly journals Cone beam CT imaging of the mandibular third molar: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR)

2019 ◽  
Vol 48 (5) ◽  
pp. 20190039 ◽  
Author(s):  
Louise Hauge Matzen ◽  
Erwin Berkhout
Keyword(s):  
European Commission ◽  
Meta Analysis ◽  
Cone Beam Ct ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Third Molars ◽  
Level Of Evidence ◽  
European Academy ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Objectives: Lack of evidence on the use of CBCT for management of mandibular third molars in Radiation Protection guideline no. 172 of the European Commission made the European Academy of DentoMaxilloFacial Radiology (EADMFR) decide to update the recommendations of the guideline. Methods and materials: A literature search was performed addressing the following questions: (1) does CBCT change the treatment of the patient?; (2) does CBCT reduce the number of post-operative sensory disturbances of the inferior alveolar nerve?; and (3) can CBCT predict the risk for a post-operative sensory disturbance of the inferior alveolar nerve? Results:  Since the European Commission published the guideline in 2012 several high-evidence studies on the use of CBCT before removal of mandibular third molars have been conducted including five randomized controlled clinical trials and one meta-analysis. Present literature allows to propose recommendations with highest level of evidence. Conclusion: New and up-to-date evidence-based recommendations advocate that CBCT imaging of the mandibular third molar should not be applied as a routine method before removal of mandibular third molars and therefore, CBCT imaging should only be applied when the surgeon has a very specific clinical question in an individual patient case that cannot be answered by conventional (panoramic and/or intraoral) imaging.

scholarly journals Prevalence of dentigerous cysts due to impaction of mandibular third molar teeth

2018 ◽  
Vol 25 (1) ◽  
Author(s):  
Hanifah Nuraini ◽  
Harmas Yazid Yusuf ◽  
Andri Hardianto
Keyword(s):  
Dentigerous Cyst ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Odontogenic Cyst ◽  
Age Group ◽  
Third Molars ◽  
Male And Female ◽  
Mandibular Third Molar ◽  
Dentigerous Cysts ◽  
Mandibular Third Molars

Dentigerous cyst is an odontogenic cyst that surrounds the crown of an impacted tooth, caused by fluid accumulation between the reduced enamel epithelium and the enamel surface, usually associated with mandibular third molars. The purpose of this study was to find out the prevalence of dentigerous cyst caused by impaction of mandibular third molar at the oral and maxillofacial surgery department of Hasan Sadikin hospital Bandung. This study was a descriptive survey study. Samples were taken from the data of patient’s medical record from July 2006 until June 2011. The result of this study showed the number of oromaxillofacial cyst cases in the period was as much as 316 (0.78%). Dentigerous cyst was the most common odontogenic cyst (48,64%). Dentigerous cyst most commonly caused by impaction of the mandibular third molar (13,89%). The amount of male and female patients with dentigerous cyst was the same (50% each). The most age group that suffered dentigerous cyst due to impaction of the mandibular third molars was the age group of 41-50 years (40%). The most chosen therapy was enucleation (100%). From the results of this study can be concluded that dentigerous cyst due to impaction of mandibular third molars was the most common case, with the same frequency found in both male and female, the most age group of impacted was the age group of 41-50 years old, and the most chosen therapy was enucleation.

scholarly journals Prevalence and Pattern of Mandibular Third Molar Impaction in Eritrean Population: A Retrospective Study

2017 ◽  
Vol 18 (2) ◽  
pp. 100-106 ◽  
Author(s):  
V Raj Kumar ◽  
Priya Yadav ◽  
Efrem Kahsu ◽  
Farhana Girkar ◽  
Rajnish Chakraborty
Keyword(s):  
Retrospective Study ◽  
East Africa ◽  
Maxillofacial Surgery ◽  
Age Groups ◽  
Third Molar ◽  
Class I ◽  
Third Molars ◽  
Mandibular Third Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

ABSTRACT Introduction The most commonly impacted tooth in the oral cavity is the mandibular third molar. Various etiologic factors have been suggested for impacted mandibular third molars. The pattern and prevalence of impacted mandibular third molars vary with different population and region. This study throws light on the prevalence and pattern of impacted mandibular third molars in Eritrea, East Africa. This is the first reported study regarding the same from Eritrea. Aim To assess the prevalence and pattern of impacted mandibular third molars in the population of Eritrea, East Africa by conducting a retrospective study from January 2009 to January 2014. Materials and methods This study was conducted in the Department of Oral and Maxillofacial Surgery, Orotta School of Medicine and Dental Medicine and the Orotta Referral Medical and Surgical Hospital, Asmara, Eritrea. A total of 1,813 clinical and radiographic records [orthopantomograms] were assessed and 276 cases were selected for the study as per the inclusion criteria. They were evaluated for the frequency among the various age groups, gender and region along with the sides affected, angulation and level of impaction. The presence of systemic conditions and associated pathologies was also assessed according to the type of impaction. Results The average age of these patients in the study was found to be 30 years, with the 20 to 30 years age group being the most affected (67.4%). Females (53.3%) were affected more than the males (46.7%). People from the Asmara region showed significantly more prevalence (79.7%) than the adjoining areas (20.3%). Mesioangular impaction was the most common angulation with a definite relationship to the age groups (p = 0.032). The level of impaction had no significant relationship to the age groups, gender, or region, although class I position A was found to be the most common type. Mesioangular class I position A impaction showed an apparent relationship with underlying systemic conditions, but it was statistically insignificant. Mesioangular impaction was found to be associated with the most number of pathologies (p = 0.001). Conclusion The prevalence of mandibular impaction was less in Eritrea (15.2%) compared with other populations. This study provides useful baseline data for the prevalence and pattern of mandibular impaction in the Eritrean population. Clinical significance This study throws light on the pattern, type, and frequency of mandibular impacted teeth as per age, sex, and region among the population of Eritrea. How to cite this article Kumar VR, Yadav P, Kahsu E, Girkar F, Chakraborty R. Prevalence and Pattern of Mandibular Third Molar Impaction in Eritrean Population: A Retrospective Study. J Contemp Dent Pract 2017;18(2):100-106.

scholarly journals Mesial Migration Effect on Root Morphology of Mandibular Third Molars

2007 ◽  
Vol 77 (1) ◽  
pp. 73-76 ◽  
Author(s):  
A. Altuğ Bıçakçı ◽  
Oral Sökücü ◽  
Hasan Babacan ◽  
H. Hüseyin Köşger
Keyword(s):  
Third Molar ◽  
Root Apex ◽  
Central Line ◽  
Occlusal Plane ◽  
Third Molars ◽  
Migration Effect ◽  
Mandibular Third Molar ◽  
Root Curvature ◽  
History Of ◽  
Mandibular Third Molars

Abstract Objective: To test the hypothesis that there is a relationship between forward mandibular third molar migration and root curvature of the mandibular third molars. Materials and Methods: The study is comprised of 64 patients who had a history of unilateral mandibular first molar extraction before 16 years of age with no other missing teeth or prosthetic restorations in the mandible. The extraction space was fully or partly closed. The mean remaining space was 1.1 ± 0.41 mm. The root angles for the mesial and distal roots of the mandibular third molars were measured on the panoramic radiographs by calculating the differences between the angle formed by the long axis drawn perpendicular to the occlusal plane of the crown of mandibular third molar and the central line of the lower one ninth of the root through the root apex. The differences between the extracted and nonextracted sides for mesial and distal roots were analyzed using a paired sample t-test. Results: Both mesial and distal roots were approximately 8° more vertical on the extraction sides than on the nonextraction sides. The differences were statistically significant. Conclusion: Mesial tooth migration of mandibular third molars reduces the amount of root curvature developing on this tooth.

scholarly journals Submucosal administration of dexamethasone versus methyl prednisolone in management of postoperative sequelae after mandibular third molar impaction - A systematic review

2020 ◽  
Vol 11 (3) ◽  
pp. 4479-4486
Author(s):  
Janani Kandamani ◽  
Divya Sanjeevi Ramakrishnan ◽  
Sudarssan Subramaniam Gouthaman ◽  
Santhosh Kumar M P
Keyword(s):  
Sodium Succinate ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Cochrane Library ◽  
Oral And Maxillofacial Surgery ◽  
Third Molar Extraction ◽  
Methylprednisolone Sodium Succinate ◽  
Methyl Prednisolone ◽  
Mandibular Third Molar

Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.

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