Cone beam CT and treatment decision of mandibular third molars: removal vs. coronectomy—a 3-year audit

Abstract

Objectives: To assess: (1) the workflow in the treatment decision process of mandibular third molars based on a panoramic image and CBCT and (2) the impact of radiographic markers in CBCT on the decision to perform coronectomy. Methods: 1437 teeth in 917 patients (mean age 27.8 years, range 18–72) underwent clinical and panoramic examination. If there was an indication for removal of the tooth, and signs of a close relation to the inferior alveolar nerve were present in the panoramic image, a CBCT was performed. Treatment decision based on panoramic image and CBCT was calculated. Statistical analyses were performed to assess whether signs in CBCT had an impact on the treatment decision “coronectomy”. Moreover, the actually operated teeth and post-operative sensory disturbances were assessed and discussed in relation to the radiographic method. Results: Based on the panoramic image, in 462 cases it was decided not to treat, 553 were scheduled for surgery, and 422 referred for a CBCT examination. “No bony separation between the tooth and mandibular canal” seen in CBCT was the main factor influencing the decision to perform a coronectomy (odds ratio = 56.8, p < 0.001). 840 mandibular third molars had undergone surgical intervention, 152 had a coronectomy and 688 were fully removed. Six patients perceived a sensory disturbance of the inferior alveolar nerve: one permanent and five temporary. Conclusion: 29% of the examined cases were referred for a CBCT and of these, the majority were scheduled for coronectomy based on the sign “no bony separation between the tooth and mandibular canal” seen in CBCT.

Knowledge and Attitude Among the Saudi Dentists Towards Coronectomy of Impacted Mandibular Third Molars

“…In clinical facilities with the advantage of 3D imaging, it will most probably lessen the recommendation of coronectomy procedure in cases with roots demonstrating more risky signs on OPG radiograph where they are shown to be above the inferior alveolar canal. 30 , 33 Even after the full removal of the tooth or a coronectomy procedure, sensory disruption might be noticed to the IAN, which is based on the operator and not on the radiographic method 58 , 59 . Nevertheless, the option of executing coronectomy or complete extraction of lower wisdom molar is still upon the decision made between the surgeon and the patient.…”

Influência de diferentes exames por imagem no planejamento cirúrgico de terceiros molares inferiores: uma revisão de literatura

“…18,19 Apesar de alguns estudos relatarem a superioridade e suficiência da RP no diagnóstico e plano de tratamento para exodontia de terceiros molares, 1,9,19,23, tratamento para o paciente. 4,13,17,26 Alguns estudos…”

Mandibular canal vs. inferior alveolar canal: Evidence‐based terminology analysis

“…The articles that were included in the IAC/IANC group were excluded from this group. The most recent, consecutive 50 articles containing “mandibular canal” but neither “inferior alveolar canal” nor “inferior alveolar nerve canal” were included (defined as the MC group) (Abd Fattah, Hariri, Nambiar, Abu Bakar, & Abdul Rahman, 2019; Al‐Shayyab, Qabba'ah, Alsoleihat, & Baqain, 2019; Alves, Dias, Mansa, & Machado, 2020; Arias et al, 2019; Bosykh, Turkina, Franco, Franco, & Makeeva, 2019; Bozkurt & Görürgöz, 2019; Burian et al, 2019; Cârstocea, Săndulescu, Hostiuc, & Rusu, 2020; M. H. Chen et al, 2019; Costa et al, 2019; Esposito et al, 2019; Felice et al, 2019; Felice, Barausse, Pistilli, Ippolito, & Esposito, 2019; Fistarol, De Stavola, Fincato, & Bressan, 2019; Freire, Nascimento, Vasconcelos, Freitas, & Haiter‐Neto, 2019; Friedrich, Matschke, & Wilczak, 2019; Iwanaga et al, 2020, 2020; Iwanaga, Wong, Kikuta, & Tubbs, 2019; Kalabalik & Aytuğar, 2019; Koç, Eroğlu, & Bilgili, 2019; Komal, Bedi, Wadhwani, Aurora, & Chauhan, 2020; K. C. Lee, Yoon, Philipone, & Peters, 2019; Liye et al, 2019; Matsuda, Yoshimura, & Sano, 2019; Matzen, Petersen, Schropp, & Wenzel, 2019; Matzen, Villefrance, Nørholt, Bak, & Wenzel, 2020; Munhoz, Arita, Nishimura, & Watanabe, 2019; Na et al, 2019; Ngeow & Chai, 2020a, 2020b; Nicol, Loncle, Pasquet, & Vacher, 2019; Okumuş & Dumlu, 2019; Oliveira et al, 2019; Ozdede, 2020; Pedersen, Matzen, Hermann, & Nørholt, 2019; Predoiu, Rusu, & Chiriţă, 2019; Puciło, Lipski, Sroczyk‐Jaszczyńska, Puciło, & Nowicka, 2020; Raju et al, 2019; Sahl, Alqahtani, Alqahtani, & Gallez, 2018; Satir, 2019; Sholapurkar & Davies, 2019; Sinha et al, 2019; Sun et al, 2019; Tereshchuk & Sukharev, 2019; Uğur Ay...…”