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 Radiographic imaging evaluation of mandibular third molars among patients presenting to private dental college in South India

2020 ◽  
Vol 11 (3) ◽  
pp. 4884-4888
Author(s):  
Jones Jayabalan ◽  
Jayakeerthana S ◽  
Muthusekhar MR
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Imaging Evaluation ◽  
Mandibular Third Molar ◽  
Mandibular Molar ◽  
Impacted Mandibular Third Molars ◽  
Study Population ◽  
Frequent Site ◽  
Reduced Space ◽  
Mandibular Third Molars

The most common reason for mandibular third molar impaction is due to reduced space between the distal part of the second mandibular molar and the anterior border of the ascending ramus of the lower jaw. The tooth that is impacted is commonly asymptomatic, or sometimes present with various pathological conditions causing pain and swelling as well as pus discharge. In our current study, we have assessed the patterns of Mandibular third molar impactions using the Orthopantomogram (OPG’s). OPG’s of 150 patients (91 female and 59 male) who were between 18-25 years of age and had impacted mandibular third molars was assessed for gender, the region having the highest frequency of impaction and the fashion of impaction of the mandibular third molars. The study shows Bilateral impaction was more commonly seen in 26.66% of the study population and case of unilateral impactions the most frequent site is particularly in left side 23.33% and in right 19.33% unilateral impactions. The mesioangular pattern of impaction was more common in both male and female and was followed by distoangular, vertical and horizontal patterns.The study showed that there was no gender bias in the presence of impacted mandibular third molars and that the mesioangular pattern of impaction was more common.

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 Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

2019 ◽  
Vol 90 (2) ◽  
pp. 181-186
Author(s):  
Un-Bong Baik ◽  
Jin Hye Kang ◽  
Ui-Lyong Lee ◽  
Nikhilesh R Vaid ◽  
Yoon-Ji Kim ◽  
...  
Keyword(s):  
Third Molar ◽  
Regression Analyses ◽  
Third Molars ◽  
Second Molar ◽  
Factors Associated ◽  
The Third ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

scholarly journals Prevalence of mandibular third molar impaction pattern in a private dental clinic of Sultanpur Lodhi

2015 ◽  
Vol 3 (2) ◽  
pp. 47
Author(s):  
Pushappreet Kaur
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Radiographic Assessment ◽  
Dental Clinic ◽  
Impacted Tooth ◽  
Mandibular Third Molar ◽  
Class 1 ◽  
Impacted Mandibular Third Molars ◽  
Tooth Number ◽  
Mandibular Third Molars

<p><strong>Background:</strong> Mandibular third molar is the most commonly impacted tooth, and its removal is a frequently performed dentoalveolar procedure. It is important to know the prevalence rate in a particular community.</p><p><strong>Objective:</strong> This article aims at evaluation of angulation, ramus relationship and depth of impacted mandibular third molars among patients visiting a private dental clinic in Sultanpur Lodhi.</p><p><strong>Methodology:</strong> 150 patients presenting with 228 cases of lower third molar impaction were included within this study. IOPAR and where necessary, OPG was used for radiographic assessment. Age, sex and tooth number were recorded in each patient on a specially designed performa. Angulation was determined using winter’s method whereas assessment of ramus relationship and depth was done using Pell and Gregory's method.</p><p><strong>Results and Conclusion: </strong>The age of patients ranged from 21-43 years with mean age of 26.6 years. Males showed preponderance to mandibular M3 impaction (54%) in our study, and right side was found more frequently involved (53%). Radiographic assessment revealed that mesioangular impaction (45.2%) was the most prevalent angular pattern followed by vertical, distoangular and horizontal types, and Class 2 Position A (29.4%) most common and Class 1 Position C the least common type of impaction depth and ramus relationship.</p>

scholarly journals Pattern of Impacted Mandibular Third Molar Teeth in Rangpur Region, Bangladesh: A Radiological Evaluation

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 8-13
Author(s):  
Md Rubayet Alam Prodhan ◽  
Md Shahidul Islam ◽  
Rifat Rezwana ◽  
Md Moynul Hasan
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Radiographic Assessment ◽  
Impacted Tooth ◽  
Panoramic Radiographs ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Molar Teeth ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Background: Third molar is the most commonly impacted tooth in the oral cavity and accounts for large of all impactions. The most common complication in the extraction of the third mandibular molars is nerve and vessels damage. Therefore, thorough radiographic assessment is a necessary to avoid these surgical complications. Objective: The purpose of this study was to evaluate the frequency, angulation, depth of the impacted mandibular third molars and its relationship with ramus on radiographs. Materials and Methods: This study comprised 800 orthopantomograms (OPGs) of patients attending different dental clinics and hospitals in Rangpur region, Bangladesh between June 2014 to May 2015. Panoromic Radiographic assessment was carried out to evaluate the pattern of third molar impaction in terms of age, gender, angulation of impaction, level of eruption and available retromolar space using panoramic radiographs and Pell & Gregory classification. Results: A total of 314 radiographic third molar areas were found in this study, out of them 137 belong to male patients and 177 belong to the female patients. The mesio angular types of angulation was most prevalent (46%) whereas distoangular was rare (5%) in our study. In relation to anterior border of the ramus of mandible Level B 52% and Class II 59% were the most common pattern of impaction. The female tends to be dominant as compared to male & the maximum number (35%) of impacted third molars are found in an age group of 38 years and above. Conclusion: Panoramic radiographs can be used as reliable investigation for evaluation of impacted mandibular third molar. KYAMC Journal.2021;12(01): 08-13

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 Odontoma kompleks pada impaksi gigi molar ketiga rahang bawah Complex odontoma in impacted mandibular third molar

2011 ◽  
Vol 10 (2) ◽  
pp. 93
Author(s):  
Rahardjo ` Rahardjo
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Anterior Maxilla ◽  
Mandibular Third Molar ◽  
Complex Odontoma ◽  
Posterior Maxilla ◽  
Impacted Mandibular Third Molars ◽  
Odontogenic Neoplasm ◽  
Mandibular Third Molars ◽  
Compound Odontoma

Odontoma is a mixed odontogenic neoplasm composed of epithelial and mesenchymal tissues. There are: compoundodontoma and complex odontoma. Compound odontoma appears to be a radiopaque mass composed of in-groupsmall teeth. Compound odontoma is generally found in the anterior maxilla, and is double in number than complexodontoma. Complex Odontoma appears to be an irregularly-shaped mass and an amorphous radiopaque image,which is often found in the posterior maxilla. Impacted mandibular third molars occur due to either insufficientspace for teeth to grow or improper dental position. Two cases of complex odontoma-generated impactedmandibular third molar were reported. Extirpation and extraction were performed on the impacted teeth.

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.

Prevalence of Distal Cervical Caries in Mandibular Second Molar caused by impacted third molar

2021 ◽  
Vol 15 (12) ◽  
pp. 3253-3256
Author(s):  
M Arshman Khan ◽  
Talib Hussain ◽  
Bilal Z. Babar ◽  
Sikandar J. Bajwa ◽  
S. Ghani ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Early Recognition ◽  
Demographic Data ◽  
Third Molar ◽  
Third Molars ◽  
Second Molar ◽  
Impacted Third Molar ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Aim: To analyse early recognition of the distal cervical caries of mandibular second molar caused by impacted mandibular third molar, to correlate oral health and caries status and to find out the average age groups and gender affected by impacted third molar Methods: A cross-sectional survey of 300 participants was conducted over a 15-month period at Rehmat Memorial Hospital, Abbottabad. 300 participants having impacted third molar having distal cervical caries in mandibular second molar were analyzed clinically and radiographically. Data was analyzed using SPSS version 23.0 Results: the demographic data of 300 patients with impacted mandibular third molars were analyzed. 64% were male and 36% female that have extractions due to impaction. Caries caused in more than half of participants by mesioangular impaction, which was 52%, 3% due to distoangular, 26% due to distal, and 18% due to horizontal impaction. In 63.25% of cases, teeth were lost due to caries, periodontitis caused 20.25% of tooth loss, pericoronitis 7.75%, orthodontics 3.75%, prosthodontics 1.2%, trauma 1%, and other factors were 2.5%. study reveals that 30.5 % of the extractions were done from 21 and 30 years and 23 %of extractions were performed. 40% of those who took part in the study did not brush their teeth. Socioeconomic status also has a great impact on tooth extractions. Conclusion: After conducting this study, it was concluded that there was a relationship between the prevalence of distal cervical caries in mandibular second molars and the placement of neighbouring impacted mandibular third molars. As a result, the extraction of mandibular third molars should be done to avoid cavities and premature tooth loss in the neighboring molar. Key words: Third molar impaction, distoangular, distal cervical caries, extraction, 2nd molar caries

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.

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