Can diagnostic changes caused by cone beam computed tomography alter the clinical decision in impacted lower third molar treatment plan?

2020 ◽  
pp. 20200412
Author(s):  
Lucas Moreira Mendonça ◽  
Hugo Gaêta-Araujo ◽  
Pedro Bastos Cruvinel ◽  
Ingrid Wenzel Tosin ◽  
Marcelo Rodrigues Azenha ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Third Molar ◽  
Clinical Decision ◽  
Cone Beam ◽  
Diagnostic Features ◽  
Operative Complications ◽  
Post Operative Complications

Objectives: This study observed whether changes in diagnosis caused by analysis of three-dimensional images can lead to alterations in the treatment plans of impacted lower third molars (ILTMs). Methods: Sets of panoramic (PAN) – cone beam computed tomography (CBCT) of 218 patients were assessed for ILTM classification, contact with mandibular canal, contact and resorption of the lower second molar (LSM), intraoperative planning and post-operative expectations. Results: Percentage agreement and McNemar test compared PAN vs CBCT assessments. Logistic regression analyzed the dependency of change in surgical planning considering the changes in diagnostic features; descriptive statistics was used to observe the expectation of post-operative complications and paresthesia. Differences were found between PAN vs CBCT for classification of impaction and positioning, LSM relationship, choice for crown and root sectioning and expectation of post-operative complications (all with p < 0.001). Logistic regression indicated that the change in diagnosis caused by CBCT examination did not change the clinical decision to extract ILTM but altered the planning of intraoperative steps such as osteotomy, crown sectioning and relaxing incision. The expectation of post-operative complications decreased when professionals planned the ILTM removal using tri-dimensional images. Conclusions: We concluded that changes in the diagnosis after CBCT examination can lead to alterations in the treatment plan of impacted lower third molar.

scholarly journals Gambaran idiopathic osteosclerosis gigi molar ketiga impaksi pada radiograf Cone Beam Computed Tomography

2021 ◽  
Vol 5 (1) ◽  
pp. 17
Author(s):  
Anak Agung Gde Dananjaya Agung ◽  
Ni Ketut Ayu Lestarini
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Third Molar ◽  
Image Resolution ◽  
Three Dimensions ◽  
Cone Beam ◽  
Mandibular Third Molar ◽  
The Right ◽  
Detailed Picture

Objectives: To analyze idiopathic osteosclerosis radiographs associated with impacted third molars (M3) on cone beam computed tomography (CBCT). Case Report: A 36-year-old woman came to the Dentology Clinic complaining that the right mandibular third molar area often felt sore. The patient was referred for CBCT examination and incidentally, a radiopaque image with clear boundaries, irregular shape was found on the periapical impacted third molar without caries in the tooth crown. The treatment plan that will be carried out on the tooth is extraction. Conclusion: Idiopathic osteosclerosis lesions are lesions that occur in vital teeth that have the characteristics of a well-defined radiopaque appearance and are asymptomatic. Characteristics of idiopathic osteosclerosis lesions can be visualized by CBCT well. CBCT has the advantage of being able to display a detailed picture of the lesion in three dimensions (3D) with a fairly good image resolution.

scholarly journals Variations in vertical mucosal thickness at edentulous ridge according to site and gender measured by cone-beam computed tomography

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Motohiro Munakata ◽  
Koudai Nagata ◽  
Minoru Sanda ◽  
Ryota Kawamata ◽  
Daisuke Sato ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Treatment Plan ◽  
Cone Beam ◽  
Alveolar Ridge ◽  
Marginal Bone Loss ◽  
Mandibular Molar ◽  
Mucosal Thickness ◽  
And Gender ◽  
Edentulous Patients

Abstract Background The vertical thickness of the peri-implant mucosa is associated with the amount of post treatment marginal bone loss. However, the variations in mucosal thickness at the different edentulous sites have been sparsely documented. The purpose of the study was to conduct a survey of the frequency distribution of variations in mucosal thickness at the different sites of the edentulous alveolar ridge and to compare them according to gender. Our study included 125 partially edentulous patients having a total of 296 implant sites. Cone-beam computed tomography (CBCT) scans were obtained by placing a diagnostic template with a radiopaque crown indicator on the ridge to determine the mucosal thickness at the crest of the alveolar ridge. Results The mucosal thickness was 3.0±1.3 mm in the maxilla, which was significantly greater than the mucosal thickness of 2.0±1.0 mm in the mandible (p<0.001). In both the maxilla and the mandible, the mucosa was the thickest in the anterior region, followed by the premolar and molar regions. Sites were further classified into two groups based on whether the mucosal thickness was greater than 2 mm. In the mandible, more than half of the sites showed a mucosal thickness of 2 mm or less. Conclusions Although this study was a limited preoperative study, the vertical mucosal thickness at the edentulous ridge differed between the maxillary and mandibular regions. The majority of sites in the mandibular molar region had a mucosal thickness of less than 2 mm. Practitioners might be able to develop an optimal dental implant treatment plan for long-term biologic and esthetic stability by considering these factors.

scholarly journals Intrusion of maxillary molar roots into the maxillary sinus in a sample of the Egyptian population using cone beam computed tomography

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Esraa Ahmed Eid ◽  
Fatma Mostafa El-Badawy ◽  
Walaa Mohamed Hamed
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Cone Beam ◽  
Egyptian Population ◽  
Maxillary Molar ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
The Right

Abstract Background The proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The aim of this study is to evaluate the relationship between each maxillary molar root and maxillary sinus floor using cone beam computed tomography. Predicting the probability of protrusion of each root into the sinus will consequently predict the probability of occurrence of the oroantral fistula in a sample of the Egyptian population. Results The total number of roots located outside the sinus was 121 (35.3%), while those contacting the sinus floor were 80 (23.3%) and those intruded the sinus were 141 (41.2%). The percentage of root intrusion into the sinus in males (56.9%) was significantly (p = 0.01) higher than females (42.9%). The probability of root intrusion in the left molars (54.2%) was non-significantly (p = 0.067) higher than that of the right side (44.3%). As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) then the first molars (40.9). According to the type of root, the mesiobuccal root showed the highest probability of intrusion into the sinus (50.9%) followed by the palatal root (49.1%) then the distobuccal root (47.4%). However, the difference in both type of tooth and type of root was statistically non-significant (p = 0.051 and 0.869 respectively). As for the individual root with the highest probability of intrusion, the mesio-buccal root of the right third molar is the most frequent root to intrude the sinus (71.4%) and the mesio-buccal root of the right first molar is the least frequent (22.7%). Conclusions In a sample of the Egyptian population, males exhibit higher probability of root protrusion into the sinus than females. The side and type of tooth are of higher impact on the probability of its intrusion into the sinus compared to the type of root. Left second molars are at a higher risk of oroantral communications on surgical or endodontic procedures compared to other molars due to its highest probability of intrusion into the sinus.

scholarly journals Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography

2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Cross Sectional ◽  
Mandibular Third Molar ◽  
The Relationship

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.

scholarly journals Predicting the Risk of Inferior Alveolar Nerve Injury in Impacted Lower Third Molars Using Panoramic Radiography and Cone Beam Computed Tomography

2021 ◽  
Vol 10 (34) ◽  
pp. 2910-2914
Author(s):  
Abhishek Verma ◽  
Stuti Verma ◽  
Anushikha Dhankhar ◽  
Nitin Kumar Moral ◽  
Nidhi Nagar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Nerve Injury ◽  
Cone Beam Computed Tomography ◽  
Panoramic Radiography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Cone Beam ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
Inferior Alveolar Nerve Injury

BACKGROUND A serious complication of surgical removal of impacted lower third molars is inferior alveolar nerve (IAN) injury. Evaluation of radiographic factors to predict IAN injury using CT and panoramic radiography includes root morphology assessment, follicular sac size, mandibular bone density, inferior alveolar nerve and vessels, condition of the overlying tissues, relation of the impacted tooth with the body and ramus of the mandible and the adjacent teeth. This study was done to evaluate the radiological features of the impacted lower mandibular teeth and their relationship with IAN through panoramic radiography and CT and to assess the most predictable radiological criteria for inferior alveolar nerve injury in impacted third molar surgery. METHODS All the patients indicated for lower third molar extraction were included in the study and pre-operative conventional panoramic radiographs (Planmeca Proline PM 2002 CC, Helsinki, Finland) and CBCT (Kodak CBCT) were taken. Any post-operative nerve injuries detected were followed up after 15 days or 1 month. Fisher’s exact test was done to find the association between the outcome variable and explanatory variables. RESULTS Only 11.4 % (N = 4) of all participants had IAN injury following surgical disimpaction. All the participants with IAN injury showed narrowing of the canal on their preoperative panoramic radiographs and presence of nerve approximation with the tooth in cone beam computed tomography (CBCT) reports (P < 0.05). CONCLUSIONS A statistically significant association exists between IAN injury and nerve exposure, radiographic signs of nerve involvement for panoramic radiograph, level of third molar impaction, and nerve approximation in CBCT. KEY WORDS Inferior Alveolar Nerve Injury, Lower Third Molar Impaction, Panoramic Radiography, CBCT

scholarly journals Frequency and Severity of Second Molar External Root Resorption Due to the Adjacent Third Molar and Related Factors: A Cone-Beam Computed Tomography Study

2021 ◽  
Author(s):  
Shirin Sakhdari ◽  
Sara Farahani ◽  
Ehsan Asnaashari ◽  
Sahel Marjani
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Resorption ◽  
Third Molar ◽  
Cone Beam ◽  
Radiology Department ◽  
Third Molars ◽  
Related Factors ◽  
Second Molar ◽  
External Root Resorption

Objective: This study sought to assess the frequency and severity of second molar external root resorption (ERR) due to the adjacent third molar and its correlation with the position of third molar and other related factors using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study evaluated 320 second molars and their adjacent impacted third molars on CBCT scans of patients over 16 years, retrieved from the archives of Azad University Radiology Department. Presence/absence of second molar ERR, its location and severity (if present), and position of adjacent third molar were determined on CBCT scans, and recorded in a checklist. Data were analyzed using a logistic regression model. Results: The frequency of second molar ERR was 33.4% in the mandible and 14% in the maxilla. The severity of ERR was significantly correlated with the involved jaw (P=0.001) but had no correlation with age, gender, or depth of impaction of adjacent third molar (P>0.05). The mesioangular and horizontal positions of impacted third molars had a significant correlation with the frequency of second molar ERR (P<0.006). Conclusion: According to the results of this study, ERR occurring in second molars adjacent to third molars is common, especially in the mandible. Mesially inclined third molars have a greater potential of being associated with ERR in second molars.

Influence of cone-beam computed tomography milliamperage settings on image quality of the mandibular third molar region

2013 ◽  
Vol 30 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Frederico Sampaio Neves ◽  
Thaís de Camargo Souza ◽  
Sérgio Lins de-Azevedo-Vaz ◽  
Paulo Sérgio Flores Campos ◽  
Frab Norberto Bóscolo
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Cone Beam ◽  
Mandibular Third Molar ◽  
Molar Region

scholarly journals Accuracy of cone-beam computed tomography in defining spatial relationships between third molar roots and inferior alveolar nerve

2016 ◽  
Vol 10 (04) ◽  
pp. 454-458 ◽  
Author(s):  
Roberto Pippi ◽  
Marcello Santoro ◽  
Ferdinando D'Ambrosio
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Morphology ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Root Surface ◽  
Cone Beam ◽  
Spatial Relationships ◽  
Third Molars ◽  
The Third

ABSTRACT Objective: Cone-beam computed tomography (CBCT) has been proposed in surgical planning of lower third molar extraction. The aim of the present study was to assess the reliability of CBCT in defining third molar root morphology and its spatial relationships with the inferior alveolar nerve (IAN). Materials and Methods: Intraoperative and radiographic variables of 74 lower third molars were retrospectively analyzed. Intraoperative variables included IAN exposure, number of roots, root morphology of extracted third molars, and presence/absence of IAN impression on the root surface. Radiographic variables included presence/absence of the cortex separating IAN from the third molar roots on CBCT examination, number of roots and root morphology on both orthopantomography (OPG) and CBCT. The statistical association between variables was evaluated using the Fisher's exact test. Results: In all cases of intraoperative IAN exposure, the cortex appeared discontinuous on CBCT images. All cases, in which the cortical bone was continuous on CBCT images, showed no association with nerve exposure. In all cases in which nerve impression was identified on the root surface, the IAN cortex showed interruptions on CBCT images. No nerve impression was identified in any of the cases, in which the cortex appeared continuous on CBCT images. CBCT also highlighted accessory roots and apical anomalies/curvatures, not visible on the OPG. Conclusions: CBCT seems to provide reliable and accurate information about the third molar root morphology and its relationship with the IAN.

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