Objectives The aim of this study was to assess panoramic radiographic signs in determining the close proximity of the impacted third molar to the inferior alveolar nerve (IAN). In addition, this study also aimed to compare the radiographic findings with the intraoperative and postoperative clinical findings and determine which radiographic sign is the most significant predictor of clinical outcomes.Methods One hundred patients (45 men, 55 women) with ages ranging from 19 to 36 years were included in the study. Panoramic radiographs of all patients showed radiographic signs suggesting a close proximity between the impacted third molar and IAN. Odontectomy of the impacted third molars was performed and patients were examined intraoperatively for exposed IAN. Patients with clinical signs of nerve affection were followed up for 6 months. Statistical analysis of data was performed using PASW Statistics 18.0 (predictive analytics software) for Windows.
ResultsThe IAN was exposed in six (6%) patients, of whom only four (4%) showed clinical signs of nerve affection. Temporary affection was observed in three patients (75%), which disappeared between 1 and 3 months postoperatively. In one patient (25%), the symptoms lasted up to 6 months. The intraoperative clinical findings showed a statistically significant association with impaction depth as P is equal to 0.028. Position C patients showed the highest prevalence of intraoperative complications. The association between postoperative findings and type of impaction was statistically insignificant (P > 0.05). Studies on significant predictors of clinical complications showed that impaction depth was a statistically significant predictor for intraoperative findings, whereas approximation was a predictor for postoperative findings.Conclusion Patients with an impacted mandibular third molar (position C) and/or an impacted third molar with roots approximating the mandibular canal should be further examined using three-dimensional (3D) radiographic modalities such as cone beam computed tomography for pertinent preoperative planning in impacted mandibular third molar surgery. Egypt J Oral
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