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 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 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 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.

Evaluation of Mandibular Third Molar Region in a Turkish Population Using Cone-Beam Computed Tomography

2020 ◽  
Vol 16 (9) ◽  
pp. 1105-1110
Author(s):  
Büyük Kaan Orhan ◽  
Dilek Yılmaz ◽  
Mehmet Ozgur Ozemre ◽  
Kıvanç Kamburoğlu ◽  
Orhan Gulen ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Mandibular Canal ◽  
Third Molars ◽  
Second Molar ◽  
The Third ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
The Relationship ◽  
Molar Region

Objectives: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. Methods: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. Results: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). Conclusion: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.

scholarly journals Modified coronectomy procedure for mandibular third molar: association of platelet-rich fibrin

2021 ◽  
Vol 69 ◽  
Author(s):  
Ronaldo Célio MARIANO ◽  
Alexandre Augusto Ferreira da SILVA ◽  
Guilherme Menali GOMES ◽  
Luis Henrique Theodoro ALVES ◽  
Marina Reis OLIVEIRA
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Mandibular Canal ◽  
Modified Technique ◽  
Present Case Report ◽  
Platelet Rich Fibrin ◽  
Good Healing ◽  
Mandibular Third Molar

ABSTRACT The present case report describes a modified technique of coronectomy for mandibular third molar with association of Platelet-Rich Fibrin Graft (PRF). The panoramic radiograph showed proximity of the roots of the vertical positioned 48 tooth with the superior wall of the mandibular canal, since the erasure of the superior cortical of the mandibular canal was observed. Due to the risk of injury to the inferior alveolar nerve, the technique of coronectomy was chosen. After the realized the coronectomy, in order to promote the regeneration of soft and hard tissues and also to prevent pulp changes that could lead to pain, pulp necrosis and infection, the PRF graft was used to fill the surgical defect formed by removal of the crown. Good healing evolution was observed and after 12 months of clinical and radiographic follow-up there was complete bone formation in the area where the crown was removed and no complications were observed.

scholarly journals Bifid mandibular canal: a rare or underestimated entity?

2016 ◽  
Vol 6 (3) ◽  
Author(s):  
Ibrahim Nasseh ◽  
Georges Aoun
Keyword(s):  
Nerve Block ◽  
Inferior Alveolar Nerve ◽  
Radiographic Finding ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Inferior Alveolar Nerve Block ◽  
The Third ◽  
Bifid Mandibular Canal ◽  
Mandibular Molar ◽  
Surgical Extraction

One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal.

scholarly journals RADIOGRAPHIC ASSESSMENT OF THE COURSE AND VISIBILITY OF THE MANDIBULAR CANAL BY PANORAMIC RADIOGRAPHY

2020 ◽  
Author(s):  
Nashwan Yahya A Al-Shamahi ◽  
Al-Kasem Mohammed Abbas ◽  
Hassan Abdulwahab Al-Shamahy ◽  
Ameen Abdullah Yahya Al-Akwa ◽  
Khaled M Al-Ghaffari ◽  
...  
Keyword(s):  
Peer Review ◽  
Panoramic Radiography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional ◽  
Panoramic Radiographs ◽  
The Third ◽  
Tract Infections ◽  
Molar Region

Background and Objectives:  The mandibular canal is a canal inside the mandible that contains the inferior alveolar artery, the inferior alveolar nerve and the inferior alveolar vein. The anatomy and variations of the human mandible are very important for planning various surgical measures such as extraction of the third molar, dental implants and mandibular reconstruction. This study was conducted to determine the frequency of the different courses of the mandibular canal  and to investigate the visibility of the mandibular canal by panoramic radiography, among a sample of Yemeni adults. Subjects and Methods: A retrospective cross-sectional study was conducted in Sana'a city on a sample of Yemeni adults. The study consisted of panoramic radiographs of 928 patients; the number of males was 340 (36.6%) and 588 females (63.4%). The mandibular canal course, as shown in the panoramic radiographs, was classified into four types: elliptical, linear, turning curves and spoon-shaped. The visibility of this canal from the first to the third molar region was assessed through visual determination of whether the lower canal was clearly visible, possibly visible, or invisible. Results:   Elliptical curves were the most observed along the mandibular canal course at 62.2% of the total, followed by the linear curve (24.8%) while the lower rate curve spoon (7.9%) and the turning curve (5.2%). There were no statistically considerable differences between the distribution of the mandibular canal courses between males and females except in the spoon curve where the ratio was 10.8% in males versus 6.1% in females (p <0.05). The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves (49.9% in the first molar, 63% in the second, 78.1% in the third molar) and the lowest among the linear curves (10.9% in the first, 18.7% in the second and 33.5% in the third molar). On panoramic radiographs, the invisible mandibular canals are found in 198 (21.3%) of the examined sites in the first molar region, in 85 (11%) in the second molar region, and in only 6 (0.64%) in the third molar region. Conclusion:  It was observed that elliptical curves along the path of the mandibular canal were the most present, while a decrease in the ratio of the two types of spoon curve and turning curve was observed. It was found that spoon curve was significantly more common among males than females. It was also found that the visibility of  madibular canal is fewer in the first molar region than in the third molar region. Peer Review History: Received: 21 September 2020; Revised: 8 October; Accepted: 29 October, Available online: 15 November 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Sunita Singh, Baylor College of Medicine, Houston, Texas, USA, [email protected] Dr. Ali Abdullah A. Al-Mehdar, Thamar University, Yemen,  [email protected]   Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

scholarly journals Is MRI a viable alternative to CT/CBCT to identify the course of the inferior alveolar nerve in relation to the roots of the third molars?

2020 ◽  
Author(s):  
Florian Beck ◽  
Stephanie Austermann ◽  
Kristina Bertl ◽  
Christian Ulm ◽  
Stefan Lettner ◽  
...  
Keyword(s):  
Direct Contact ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Preoperative Assessment ◽  
Spatial Relation ◽  
Viable Alternative ◽  
Third Molars ◽  
The Third ◽  
Mandibular Third Molar ◽  
Good Agreement

Abstract Objectives To assess the reliability of judging the spatial relation between the inferior alveolar nerve (IAN) and mandibular third molar (MTM) based on MRI or CT/CBCT images. Methods Altogether, CT/CBCT and MRI images of 87 MTMs were examined twice by 3 examiners with different degrees of experience. The course of the IAN in relation to the MTM, the presence/absence of a direct contact between IAN and MTM, and the presence of accessory IAN were determined. Results The IAN was in > 40% of the cases judged as inferior, while an interradicular position was diagnosed in < 5% of the cases. The overall agreement was good (κ = 0.72) and any disagreement between the imaging modalities was primarily among the adjacent regions, i.e., buccal/lingual/interradicular vs. inferior. CT/CBCT judgements presented a very good agreement for the inter- and intrarater comparison (κ > 0.80), while MRI judgements showed a slightly lower, but good agreement (κ = 0.74). A direct contact between IAN and MTM was diagnosed in about 65%, but in almost 20% a disagreement between the judgements based on MRI and CT/CBCT was present resulting in a moderate overall agreement (κ = 0.60). The agreement between the judgements based on MRI and CT/CBCT appeared independent of the examiner’s experience and accessory IAN were described in 10 cases in MRI compared to 3 cases in CT/CBCT images. Conclusions A good inter- and intrarater agreement has been observed for the assessment of the spatial relation between the IAN and MTM based on MRI images. Further, MRI images might provide advantages in the detection of accessory IAN compared to CT/CBCT. Clinical relevance MRI appears as viable alternative to CT/CBCT for preoperative assessment of the IAN in relation to the MTM.

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.

Sign in / Sign up

Export Citation Format

Share Document