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Year : 2022  |  Volume : 34  |  Issue : 4  |  Page : 423-427

Evaluation of the spatial relationship of impacted mandibular third molar to mandibular canal using CBCT: A descriptive study

Department of Oral Medicine and Radiology, Government Dental College, Thiruvananthapuram, Kerala, India

Correspondence Address:
Jesmith Elsa Jacob
Thykoothattil House, Pullad P.O., Thiruvalla, Pathanamthitta Dist., Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jiaomr.jiaomr_282_21

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Introduction: Impaction is defined as the “lack of eruption of a tooth in the oral cavity within the time and physiological limits of the normal eruption process.” The prevalence of damage to the inferior alveolar nerve during surgical extraction of impacted mandibular third molars, resulting in transient/permanent dysesthesia or paresthesia, is around 0.4% to 13.4%. Aims and Objectives: The study's goal was to use cone beam computed tomography (CBCT) to examine the three-dimensional anatomic association between the impacted mandibular third molars and the mandibular canal and to develop a risk prediction model to screen inferior alveolar nerve injuries. Materials and Methods: DICOM files of 300 cases were retrieved and analyzed according to the parameters. Descriptive statistics and a Chi-square test were used to assess the association between different variables and logistic regression to develop a risk prediction model to screen inferior alveolar nerve injuries. Results: Inter-observer and intra-observer agreements were excellent for all CBCT variables. Direct contact of the third molar with the mandibular canal was seen in 61.7% of the cases. Statistically significant association was found for loss of corticalization (OR-5.95; P = 0.000), narrowing (OR-18.916; P = 0.000), and dilacerations of roots (OR-3.8; P = 0.004) with “direct contact” of the impacted mandibular third molar to the mandibular canal. Conclusion: Preoperative assessment with CBCT entails the opportunity to ascertain the “high-risk” impacted mandibular third molars at a cheaper cost, with less equipment maintenance and reduced exposure, compared to computed tomography (CT) imaging.

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