The prognostic value of panoramic radiography of inferior alveolar nerve damage after mandibular third molar removal: retrospective study of 400 cases

Szalma, József; Lempel, Edina; Jeges, Sára; Szabó, Gyula; Olasz, Lajos

doi:10.1016/j.tripleo.2009.09.023

Cited by 91 publications

(90 citation statements)

References 28 publications

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“…3 In the present study, we used the most common signs (darkening of roots, diversion of mandibular canal, narrowing of mandibular canal and interruption in white line) associated with a higher risk of IAN injury [15][16][17][18] (Figure 1). On the CBCT images, the presence or absence of corticalization between the mandibular third molar and the mandibular canal was evaluated using cross-sectional images.…”

Section: Methodsmentioning

confidence: 99%

Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

Neves¹,

Souza²,

Almeida³

et al. 2012

Dentomaxillofacial Radiology

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Objectives: The aim of this study was to assess the reliability of four panoramic radiographic findings, both individually and in association, in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam CT (CBCT) images. Methods: The sample consisted of 72 individuals (142 mandibular third molars) who underwent pre-operative radiographic evaluation before extraction of impacted mandibular third molars. On panoramic radiographs, the most common signs of corticalization (darkening of roots, diversion of mandibular canal, narrowing of mandibular canal and interruption of white line) and the presence or absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were evaluated. Results: Darkening of roots and interruption of white line associated with the absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were statistically significant, both as isolated findings (p50.0001 and p50.0006, respectively) and in association (p50.002). No statistically significant association was observed for the other panoramic radiographic findings, either individually or in association (p . 0.05). Conclusion: Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal, requiring threedimensional evaluation of the case.

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Section: Methodsmentioning

confidence: 99%

Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

Neves¹,

Souza²,

Almeida³

et al. 2012

Dentomaxillofacial Radiology

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“…However, some studies show that despite their utility, these signs cannot prevent the appearance of paresthesiae during undertaking the operative maneuvers necessary for their removal. Furthermore, Szalma et al [32], when comparing conventional OPG with digital OPG (Figure 5), did not describe any significant difference regarding the predictive value of these studies.…”

Section: Right Radiographic Diagnosismentioning

confidence: 83%

Prevention and Treatment of IAN Injuries: A Literature Review

2014

J Interdiscipl Med Dent Sci

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The inferior alveolar nerve (IAN) is one of the most important structures in dentistry. It is a terminal branch that originates from the mandibular root of the trigeminal nerve. This branch courses through the inner aspect of the mandible and innervates teeth and some muscles as the mylohyoid or digastric ones and the gums or lips by its mental branch.Although the main cause of IAN lesion occurs during third molars extractions, IAN can be injured during implant surgery, especially in cases with an atrophic posterior mandible. It is difficult to sever the nerve due to its large caliber. On the contrary, nerve compression or laceration constitute more common complications.Diverse preventive methods to avoid IAN injury have been reported such as using a precise diagnostic procedure as computerized tomography (CT), guided implant surgery, or placing short implants.We may classify nerve injury effects ranging from a light tingling (dysesthesia) to temporary or permanent loss of sensibility (hypoesthesia) or to increased sensibility. These cases require a careful management as these events may increase the patients' and dental practitioners' anxiety. When the IAN has not been totally interrupted, healing occurs in the next 3 to 6 month even spontaneously.Sometimes we can alleviate patients giving them some painkillers or vitamin complexes to minimize symptoms or to improve healing. The use and utility of this kind of treatment is controversial however we should not underestimate its placebo effects.

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Section: A Coronectomia Céljaunclassified

“…A reverzibilis IAN-sérülések gyakorisá-ga irodalmi adatok szerint 0,4 és 8,4% közé esik, az irreverzibilis sérülések gyakorisága pedig általában 1% alatti [1]. Amennyiben előzetes röntgenvizsgálattal az idegsé-rülés esélyét növelő rizikójelet, rizikójeleket látunk [1][2][3][4][5][6][7] (1. ábra) és/vagy egy háromdimenziós képalkotó eljárás (komputertomográfia -CT, cone beam CT -CBCT) megerősíti a bölcsességfog és a canalis direkt kapcsolatát (canalis csontos falának hiánya), több terápiás választá-sunk is lehet. A fog teljes eltávolítása mellett szóba jöhet a bölcsességfog orthodontiai extractiója (fogszabályozó eszközökkel a fog lassú "kivontatása") [8], a pericoronalis ostectomia (a részlegesen előtört fogat körbevevő szövetek műtéti elvétele) [9], a fogkoronai szekciókkal segített migráltatás [10], az endoszkóp által vizuálisan támogatott alveoluson belüli fogdarabolás [11] és a coronectomia [12,13].…”

Section: A Coronectomia Céljaunclassified

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A nervus alveolaris inferior védelmében: alsó bölcsességfogak coronectomiája. Irodalmi áttekintés

Szalma

Lempel

2017

Orvosi Hetilap

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A jelen tudományos közleményt a szerzők a Pécsi Tudományegyetem alapításának650. évfordulója tiszteletére közlik.Az alsó bölcsességfogak coronectomiája a bölcsességfog részleges eltávolításával hivatott az esetleges nervus alveolaris inferior sérüléseit kiküszöbölni. Az eljárásnak van néhány sarkalatos pontja, úgymint a fog pulpalis, periapicalis preoperatív állapota, a koronai sectio és koronaeltávolítás, illetve a sebzárás mikéntje, valamint a páciens posztoperatív követése és az esetlegesen felmerülő szövődmények ismerete és kezelése. Szakirodalmi adatok szerint a coronectomia kevesebb szövődménnyel bír, mint a hagyományos, teljes fogeltávolítások, és a nervus alveolaris inferior sérülések szempontjából a coronectomia egyértelműen és kifejezetten a biztonságosabb eljárás. A szerzők célja volt a szakirodalmat áttekintve, az eljárás indikációiról és kontraindikációiról, korrekt kivitelezéséről és az esetleges sikertelenségé-nek okairól, gyakoriságairól átfogó képet adni, előmozdítva az eljárás hazai népszerűsítését. Orv Hetil. 2017; 158(45): 1787-1793. Kulcsszavak: nervus alveolaris inferior, impaktált bölcsességfog, paraesthesia, coronectomiaProtecting the inferior alveolar nerve: coronectomy of lower third molars ReviewCoronectomy of lower impacted wisdom teeth is the partial removal of third molars, aiming to avoid inferior alveolar nerve injuries. The coronectomy procedure has several crucial points, such as the pulpal, periapical preoperative conditions of the tooth, the way of crown sectioning and decoronation, the wound closure and the length of patients' follow up. In addition it is important to identify and manage possible intraoperative or postoperative complications correctly. According to the literature, the complication rate of coronectomy is usually lower, than that of total teeth removal, furthermore considering inferior alveolar nerve injuries, coronectomy is significantly the safer procedure. The aim of the authors was to review the relevant literature, defining the indications, contraindications and the correct implementation of the coronectomy and to demonstrate the causes and incidences of failures and complications.Further aim was to promote the domestic acceptance of this procedure.Keywords: inferior alveolar nerve, impacted third molar, paresthesia, coronectomy Rövidítések CBCT = "cone beam" komputertomográfia; CT = komputertomográfia; IAN = nervus alveolaris inferior; LN = nervus lingualis; OENO = Orvosi Eljárások Nemzetközi Osztályozása, a járóbeteg-szakellátásban elszámolható vizsgálati és beavatkozá-si tevékenységek listája; ZC = zománc-cement határvonal

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The prognostic value of panoramic radiography of inferior alveolar nerve damage after mandibular third molar removal: retrospective study of 400 cases

Cited by 91 publications

References 28 publications

Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

Prevention and Treatment of IAN Injuries: A Literature Review

A nervus alveolaris inferior védelmében: alsó bölcsességfogak coronectomiája. Irodalmi áttekintés

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