Neurosensoric disturbances after surgical removal of the mandibular third molar based on either panoramic imaging or cone beam CT scanning: A randomized controlled trial (RCT)

Abstract

The use of CBCT before removal of the mandibular third molar does not seem to reduce the number of neurosensoric disturbances.

Radiographic signs of pathology determining removal of an impacted mandibular third molar assessed in a panoramic image or CBCT

“…6,[8][9][10][11][12][13] Another reason to perform CBCT may be to clarify the presence of pathology in relation to the third molar, which could be decisive for removal, even in lack of patient symptoms. This study has focused on the association between findings in PAN and CBCT in terms of resorption and marginal bone loss in/at the distal surface on the second molar and increased periodontal space around the crown of the third molar.…”

“…7 Further, it has been shown in randomized controlled clinical trials that CBCT before removal did not decrease the number of sensory disturbances to the inferior alveolar nerve compared with panoramic imaging. [8][9][10] On the other hand, it was speculated that CBCT could be indicated in cases of doubt after interpreting the panoramic image (PAN) with regard to the presence of root resorption in the distal surface of the second molar, if this was indicative for removal of the tooth. 11 The aim of this study was to compare pathological findings observed in a PAN and CBCT taken prior to removal of a mandibular third molar, in the assessment of resorption in the distal surface of the second molar, marginal bone loss at the distal root surface of the second molar and the presence of an increased periodontal space around the crown of the third molar.…”

Inferior alveolar nerve injury: Correlation between indicators of risk on panoramic radiographs and the incidence of tooth and mandibular canal contact on cone‐beam computed tomography scans in a Western Australian population

“…In the case of mandibular third molars, inferior alveolar nerve (IAN) damage could result in paresthesia or impairment of perception, including dysesthesia and/or anesthesia of the teeth, lip, and chin . The incidence of permanent damage to the IAN is consistently reported in the literature to occur in less than 1% of all cases . However, the incidence of temporary damage is less consistent, ranging from 26% to 13% of all cases .…”

Are different imaging methods affecting the treatment decision of extractions of mandibular third molars?

“…If the relationship of the tooth roots and the inferior alveolar canal is not clear, the surgeon would recommend to decide after CBCT imaging. However, Petersen et al 10 found that CBCT was not superior to panoramic imaging in avoiding neurosensoric disturbances and concluded that the use of CBCT before removal of the mandibular third molar does not seem to reduce the number of neurosensoric disturbances. Guerrero et al 11,12 concluded that CBCT was not better than panoramic radiography in predicting post-operative complications for moderaterisk cases of impacted lower third molars.…”