Is juxta-apical radiolucency a reliable risk factor for injury to the inferior alveolar nerve during removal of lower third molars?

Gilvetti, Ciro; Haria, Sonam; Gulati, Aakshay

doi:10.1016/j.bjoms.2018.11.022

Cited by 9 publications

(18 citation statements)

References 25 publications

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“…Consistent with our ndings, a study by Alling et al showed that 96% of inferior alveolar nerve injuries recovered within 4-8 weeks after surgery [21]. There is only another study investigating the relationship between paresthesia and JAR in panoramic images, which indicated no signi cant relationship [9]. However, our study was based on CBCT images, as JAR detection is more accurate in CBCT images than panoramic images [14].…”

Section: Discussionsupporting

confidence: 86%

“…In this regard, Umar et al [10] reported that JAR originates from the superimposition of a large cancellous bone on the mandibular canal. Also, Gilvetti et al [9] studied 50 cases of JAR in panoramic images and found no temporary or permanent paresthesia after at least 18 months. Yalcin and Artas [15] con rmed this result, as they found no signi cant relationship between JAR and the mandibular canal.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, Gilvetti et al evaluated paresthesia in patients with JAR following the third molar surgery, based on panoramic radiography. According to their study, the presence of JAR is not a reliable predictor of the risk of permanent injury to the inferior alveolar nerve [9].…”

Section: Introductionmentioning

confidence: 92%

“…The radiographic position of the mandibular third molars relative to the mandibular canal has been shown to be useful in assessing the risk of damage to the inferior alveolar nerve following extraction [6][7][8]. Seven radiographic signs can increase the incidence of injury to the inferior alveolar nerve, including the darkening of the roots, diversion of the canal, and interruption of the white line of the canal, which are assumed to be the best predictive signs of neurosensory de cits [9]. In 2005, Renton et al introduced the juxta-apical area (JAA) or juxta-apical radiolucency (JAR) as a new predictive sign [4].…”

Section: Introductionmentioning

confidence: 99%

“…Considering the limitations of previous studies, which mostly applied panoramic radiography [9,13] and lacked a control group [9,15], in this case-control study, we aimed to determine the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of paresthesia after mandibular third molar surgeries. Moreover, we scrutinized whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the Presence of Paresthesia in Patients with Juxta-apical Radiolucency after Third Molar Surgery: A Case-control Study

Hasani

Razavi

Haghnegahdar

et al. 2021

Preprint

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Background: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with paresthesia in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.Methods: Of an initial sample of 545 mandibular third molars, a total of 75 JAR and 75 control teeth were evaluated by CBCT. The association of JAR with the IAN, position to IAN, lingual cortical plate thinning, and tooth angulation was investigated in this study. Temporary and permanent paresthesia were also examined in the subjects. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis.Results: A significant relationship was found between JAR and temporary paresthesia (P=0.034). However, there was no case of permanent paresthesia. JAR showed no significant relationship with the tooth angulation, cortical plate thinning, position to IAN and proximity to the mandibular canal. The lingual position of JAR relative to the mandibular canal was related to the presence of paresthesia in the JAR group. Also, most cases of paresthesia showed some degree of lingual cortical plate thinning (P=0.012). Conclusion: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary paresthesia. The present findings may indicate the increased risk of nerve injury during the surgical removal of third molars.

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Section: Discussionsupporting

confidence: 86%