Reliability of cone beam computed tomography in comparison with panoramic radiography to predict the anatomical relationship of inferior alveolar nerve with mandibular third molar: A radiological and clinical study

Abstract

A BSTRACT Objectives: The purpose of the study was to assess the precision of cone beam computed tomography (CBCT) in comparison with panoramic radiography in determining the anatomical relationship of inferior alveolar nerve (IAN) with the impacted mandibular third molar. Materials and Methods: Twenty patients diagnosed with the following panoramic radiographic markers: darkening of the root, interruption of white line of mandibular canal, diversion of mandibular canal, and narrowing of the roots suggesting a close relationship of roots with the mandibular canal were selected and underwent an additional CBCT to assess the proximity of IAN to mandibular third molar roots. All patients were assessed for loss of sensation or neurosensory deficit in the chin and lower lip during postoperative period by objective and subjective methods. Results: Twenty patients with an average age of 25.4 years (21–39 years) with 21 impacted mandibular third molars were included in this sample. It was found that after the removal of impacted third molars, IAN was not visible in any of the cases and postoperative objective and subjective neurosensory tests showed no signs of neurosensory disturbances. Conclusion: The study found that CBCT had limited usefulness in neurovascular bundle exposure prediction, prior to surgical removal of impacted mandibular third molars. The accuracy of radiographic markers in conventional panoramic radiography to predict neurovascular exposure was also limited.

Relación anatómica del conducto alveolar inferior con respecto a los terceros molares clase II mediante la técnica Cone-Beam

“…El uso de la tomografía computarizada de Cone-Beam es considerado uno de los mejores medios de diagnóstico para determinar la relación del conducto alveolar inferior con los terceros molares, ya que permite realizar mediciones precisas de las diferentes variables presentadas, así como en varios estudios, 22,29,30 en los cuales se hace mención de una escasa fiabilidad de los signos radiográficos para la predicción de la proximidad de la raíz de terceros molares inferiores con el canal mandibular en radiografía panorámica, creando controversia y preguntas sobre la radiografía panorámica y su fiabilidad comparada con los resultados de la CBCT que se encuentran mucho más exactos.…”

Artificial intelligence in dentistry: A boon or bane?

“…22 CBCT can be used to accurately visualise the proximity of the third molar to the inferior alveolar nerve predicting the difficulty in its surgical removal. 23…”