Use of dental panoramic tomographs to predict the relation between mandibular third molar teeth and the inferior alveolar nerve. Radiological and surgical findings, and clinical outcome

Abstract

Objectives: To compare preoperative radiological observations from dental panoramic tomographs (DPT), with surgical findings at removal of third molars with respect to the inferior alveolar nerve.

Study design: One surgeon viewed the radiographs of 219 patients and recorded the radiological observations of the mandibular third molar tooth and the inferior alveolar nerve. The same surgeon removed the teeth and made detailed records of morphology of the root and its relation to the inferior alveolar nerve. Patients were reviewed postoperatively.

Results: A total of 300 teeth were removed and the neurovascular bundle was directly observed the root was grooved, or roots apices were deflected by the bundle in 35 (12%) cases. Postoperatively no patient had altered labial sensation.

Conclusion: There was an intimate relation between the mandibular third molar tooth and the inferior alveolar nerve in 12 (51%) cases when darkening of the root was observed, and in only 11 (11%) cases when interruption of the radiopaque outline of the inferior alveolar neurovascular bundle was observed.