Evaluation of the anatomical relationship between mandibular third molars and the mandibular canal using Cone Beam Computed Tomography

Authors

DOI:

https://doi.org/10.33448/rsd-v10i6.15659

Keywords:

Inferior Alveolar Nerve; Third molar; Cone beam computed tomography.

Abstract

Objective: This study aims to establish the anatomical relationship between the mandibular canal and the third molars, based on analysis by Cone Beam Computed Tomography. Methodology: Computed Tomography analysis of 67 third molars was performed using Blue Sky Plan 4 virtual planning software. The anatomical dispositions of the third molars and mandibular canal were evaluated, as well as the factors that favor the contact between these structures. Result: There was a prevalence of 76.1% for biradicular third molars, 52.2% for class 1 and 71.6% class A. Vertical and mesioangulated teeth had a higher prevalence, with 38.8% and 35.8% respectively. Sicher and Tandler's classification presented 41.8% of the canals as type I, while in the buccal-lingual positioning, 89.5% of the canals were located through the buccal. 44.8% of the teeth had contact with the canal and the factors with statistical significance were: female gender (p = 0.019), number of roots (p = 0.019), class 3 (p = 0.004) and C (p = 0.012) teeth and lingual positioning of the mandibular canal (p = 0.016). About the anatomical delimitations, the mean diameter of the canal was 3.14 mm and the distances related to the dental roots, lingual, buccal and inferior cortical bony were 2.77, 3.53, 4.56 and 8.32 milimeters, respectively. Conclusion: Therefore, the assessment of third molars by computed tomography is essential during preoperative planning, as it identifies anatomical relationships that favor contact between the tooth and the mandibular canal and helps to reduce the incidence of sensorineural disorders.

References

Almendroz-Marqués, N., Berini-Aytés, L., & Gay-Escoda, C. (2006). Influence of lower third molar positions on the incidence of preoperative complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 102:725-32.

Cheung, L. K., Leung, Y. Y., Chow, L. K., Wong, M. C. M., Chan, E. K. K., & Fok, Y. H. (2010). Incidence of neurosensory deficits and recovery after lower third molar surgery: a prospective clinical study of 4338 cases. Int J Oral Maxillofac Surg, 39:320–326.

Deshpande, P., Guledgud, M. V., & Patil, K. (2013). Proximity of Impacted Mandibular Third Molars to the Inferior Alveolar Canal and Its Radiographic Predictors: A Panoramic Radiographic Study. J. Maxillofac. Oral Surg, 12(2):145–151.

Figún, M. E., & Garino, R. R. (2003). Anatomia odontológica funcional e aplicada. Artmed.

Ghaeminia, H., Meijer, G. J., Soehardi, A., Borstlap, W. A., Mulder, J., & Berge, S. J. (2009). Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. Int J Oral Maxillofac Surg, 38:964–971.

Gu, L., Zhu, C., Chen, K., Liu, X., & Tang, Z. (2018). Anatomic study of the position of the mandibular canal and corresponding mandibular third molar on conebeam computed tomography images. Surg Radiol Anat, 40: 609–614.

Gupta, S., Bhowate, R. R., Nigam, N., & Saxena, S. (2011). Evaluation of impacted mandibular third molars by panoramic radiography. ISRN Dent, 8p.

Kim, H. G., & Lee, J. H. (2014). Analysis and evaluation of relative positions of mandibular third molar and mandibular canal impacts. J Korean Assoc Oral Maxillofacial Surg, 40:278-284

Maegawa, H., et al. (2003). Preoperative assessment of the relationship between the mandibular third molar and the mandibular canal by axial computed tomography with coronal and sagital reconstruction. Oral Surg Oral Med Oral Pathol. Oral Radiol Endod., 96: 639-46.

Mahasantipiya, P. M., Savage, N. W., Monsour, P. A., & Wilson, R. J. (2005). Narrowing of the inferior dental canal in relation to the lower third molars. Dentomaxillofac Radiol, 34:154-63

Maravilha, T. A. R. Avaliação tridimensional da relação do canal mandibular com a posição radicular do terceiro molar mandibular. [Dissertação de mestrado]. Instituto de ciências da Saúde da Universidade Católica Portuguesa; (2016). 103 p. Mestrado em medicina dentária.

Miloro, M., & DaBell, J. (2005). Radiographic proximity of the mandibular third molar to the inferior alveolar canal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 100:545-9.

Monaco, G., Montevecchi, M., Alessandri Bonetti, G., Gatto, M. R. A., & Checchi, L. (2004). Reliability of panoramic radiography in evaluating the topographic relationship between the mandibular canal and impacted third molars. J Am Dent Assoc. 135:312–318.

Nakayama, K., Nonoyama, M., Takaki, Y., Kagawa, T., Yuasa, K., Izumi, K., Ozeki, S., & Ikebe, T. (2009). Assessment of the relationship between impacted mandibular third molars and inferior alveolar nerve with dental 3-dimensional computed tomography. J Oral Maxillofac Surg 67:2587–91.

Ohman, A., Kivijarvi, k.. Blomback, U., & Flygare, L. (2006). Pre-operative radiographic evaluation of lower third molars with computed tomography. Dentomaxillofac Radiol, 35: 30–35.

Peker, I., Sarikir, C., Alkurt, M. T., & Zor, Z. F. Panoramic radiographic and cone beam computed tomography findings in preoperative examination of impacted third molars. BMC Oral Health. 14:71.

Primo, F. T., Primo, B. T., Scheffer, M. A. R., Hernández, P. A. G., & Rivaldo, E. G. (2017). Evaluation of 1211 third molars positions according to the classification of Winter, Pell & Gregory. Int. J. Odontostomat, 11(1):61-65.

Sedaghatfar, M., August, M. A., & Dodson, T. B (2005). Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. J Oral Maxillofac Surg, 63:3–7

Suomalainen, A., Ventä, I., Mattila, M., Turtola, L., Vehmas, T., & Peltola, J. S. (2010). Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 109:276-84.

Susarla, S. M., & Dodson, T. B. (2007). Preoperative computed tomography imaging in the management of impacted mandibular third molars. J Oral Maxillofac Surg; 65:83-8.

Tantanapornkul, W., Okouchi, K., Fujiwara, Y., Yamashiro, M., Maruoka, Y., Ohbayashi, N., & Kurabayashi, T. (2007). A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103: 253–259.

Valmaseda-Castellon, E., Berini-Aytes, L., & Gay-Escoda, C. (2001). Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1,117 surgical extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 92:377–383.

Downloads

Published

09/06/2021

How to Cite

BATISTA, M. V. S. .; MOTTA JUNIOR, J. Evaluation of the anatomical relationship between mandibular third molars and the mandibular canal using Cone Beam Computed Tomography. Research, Society and Development, [S. l.], v. 10, n. 6, p. e55710615659, 2021. DOI: 10.33448/rsd-v10i6.15659. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/15659. Acesso em: 21 nov. 2024.

Issue

Section

Health Sciences