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The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram

Received: 17 November 2020     Accepted: 30 November 2020     Published: 8 December 2020
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Abstract

Introduction: A tooth that is unable to erupt completely due to some physiological barrier is called impaction. The extraction of the impacted mandibular 3rd molar is the most frequent procedure in oral surgery. The removal of 3rd molar is associated with complications like damage to the inferior alveolar nerve which causes paresthesia of the lower lip depending upon the severity of the damage. Objectives: This study assesses the diagnostic efficacy of orthopantomograph in predicting the association between mandibular third molar roots and inferior alveolar canal and its juxtaposition with intra-operative surgical findings. Material and methods: This cross-sectional research was conducted in the department of Oral & Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore, requiring extraction of mandibular third molars surgically. Patients underwent extraction under local anesthesia. The association between M3 and IAC by comparing OPG findings with intra-operative surgical findings was assessed by chi-square analysis. Results: One hundred and twenty patients requiring mandibular third molar extraction were included in the study. The age of the patients involved in the study ranged from 21-70 years. There were 5 cases of nerve injury in the age group of 31-40 and 1 case in each age group of 21-30 and 41-50. Conclusion: The chances of nerve damage also increase significantly when there is more than one radiographic sign present and the tooth is deeply placed in the mandible nearest to the IAN.

Published in International Journal of Clinical Oral and Maxillofacial Surgery (Volume 6, Issue 2)
DOI 10.11648/j.ijcoms.20200602.17
Page(s) 56-59
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Impaction, Inferior Alveolar Nerve, Neurosensory Dysfunction, Orthopantomograph

References
[1] Leung YY, Cheung LK. Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies. Int J Oral Maxillofac Surg. 2011; 40: 1–10.
[2] Kjølle GK, Bjørnland T. Low risk of neurosensory dysfunction after mandibular third molar surgery in patients less than 30 years of age. A prospective study following removal of 1220 mandibular third molars. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2013; 116 (4), 411–417. doi: 10.1016/j.oooo.2013.06.024.
[3] Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc. 2007; 73: 325.
[4] Genù PR, Vasconcelos BCE. Influence of the tooth section technique in alveolar nerve damage after surgery of impacted lower third molars. Int J Oral Maxillofac Surg. 2008; 37: 923–928.
[5] Szalma J, Lempel E, Jeges S, Szabó G, Olasz L. The prognostic value of panoramic radiography of inferior alveolar nerve damage after mandibular third molar removal: a retrospective study of 400 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 294–302.
[6] Jerjes W, Upile T, Shah P, Nhembe F, Gudka D, Kafas P, et al. Risk factors associated with injury to the inferior alveolar and lingual nerves following third molar surgery revisited. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 335–345.
[7] Flygare L, Öhman A. Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Investig. 2008; 12: 291–302.
[8] Palma-Carrio C, Garcia-Mira B, Larrazabal-Moron C, Penarrocha-Diago M. Radiographic signs associated with inferior alveolar nerve damage following lower third molar extraction. Med Oral Patol Oral Cir Bucal. 2010; 15: 886–890.
[9] Céspedes-Sánchez JM, Ayuso-Montero R, Marí-Roig A, Arranz-Obispo C, López-López J. The importance of a good evaluation in order to prevent oral nerve injuries: a review. Acta Odontol Scand. 2014; 72: 161–167.
[10] Valmaseda-Castellon E, Berini Aytès L, Gay-Escoda C. Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 377–383.
[11] Celikoglu, M., Miloglu, O., & Kazanci, F. Frequency of Agenesis, Impaction, Angulation, and Related Pathologic Changes of Third Molar Teeth in Orthodontic Patients. Journal of Oral and Maxillofacial Surgery, 2009; 68 (5), 990–995. doi: 10.1016/j.joms.2009.07.063.
[12] Ishfaq M, Wahid A, Rahim AU, Munim A. Patterns and presentations of impacted mandibular third molars subjected to removal at khyber college of dentistry peshawar. Pakistan oral & dent. Jr. 26 (2) dec. 2006.
[13] Sarikov R, Juodzbalys G. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofac Res. 2014; 5 (4): e1. Published 2014 Dec 29. doi: 10.5037/jomr.2014.5401.
[14] La Monaca G, Vozza I, Giardino R, Annibali S, Pranno N, Cristalli MP. Prevention of neurological injuries during mandibular third molar surgery: technical notes. Ann Stomatol (Roma). 2017; 8 (2): 45-52. Published 2017 Nov 8. doi: 10.11138/ads/2017.8.2.053.
[15] Loescher, A. R., Smith, K. G., & Robinson, P. P. Nerve Damage and Third Molar Removal. Dental Update. 2003; 30 (7): 375–382. doi: 10.12968/denu.2003.30.7.375.
Cite This Article
  • APA Style

    Muhammad Ikram Khan, Omer Sefvan Janjua, Muhammad Hammad, Riaz Ahmad Warraich. (2020). The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram. International Journal of Clinical Oral and Maxillofacial Surgery, 6(2), 56-59. https://doi.org/10.11648/j.ijcoms.20200602.17

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    ACS Style

    Muhammad Ikram Khan; Omer Sefvan Janjua; Muhammad Hammad; Riaz Ahmad Warraich. The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram. Int. J. Clin. Oral Maxillofac. Surg. 2020, 6(2), 56-59. doi: 10.11648/j.ijcoms.20200602.17

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    AMA Style

    Muhammad Ikram Khan, Omer Sefvan Janjua, Muhammad Hammad, Riaz Ahmad Warraich. The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram. Int J Clin Oral Maxillofac Surg. 2020;6(2):56-59. doi: 10.11648/j.ijcoms.20200602.17

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  • @article{10.11648/j.ijcoms.20200602.17,
      author = {Muhammad Ikram Khan and Omer Sefvan Janjua and Muhammad Hammad and Riaz Ahmad Warraich},
      title = {The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram},
      journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
      volume = {6},
      number = {2},
      pages = {56-59},
      doi = {10.11648/j.ijcoms.20200602.17},
      url = {https://doi.org/10.11648/j.ijcoms.20200602.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20200602.17},
      abstract = {Introduction: A tooth that is unable to erupt completely due to some physiological barrier is called impaction. The extraction of the impacted mandibular 3rd molar is the most frequent procedure in oral surgery. The removal of 3rd molar is associated with complications like damage to the inferior alveolar nerve which causes paresthesia of the lower lip depending upon the severity of the damage. Objectives: This study assesses the diagnostic efficacy of orthopantomograph in predicting the association between mandibular third molar roots and inferior alveolar canal and its juxtaposition with intra-operative surgical findings. Material and methods: This cross-sectional research was conducted in the department of Oral & Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore, requiring extraction of mandibular third molars surgically. Patients underwent extraction under local anesthesia. The association between M3 and IAC by comparing OPG findings with intra-operative surgical findings was assessed by chi-square analysis. Results: One hundred and twenty patients requiring mandibular third molar extraction were included in the study. The age of the patients involved in the study ranged from 21-70 years. There were 5 cases of nerve injury in the age group of 31-40 and 1 case in each age group of 21-30 and 41-50. Conclusion: The chances of nerve damage also increase significantly when there is more than one radiographic sign present and the tooth is deeply placed in the mandible nearest to the IAN.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram
    AU  - Muhammad Ikram Khan
    AU  - Omer Sefvan Janjua
    AU  - Muhammad Hammad
    AU  - Riaz Ahmad Warraich
    Y1  - 2020/12/08
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijcoms.20200602.17
    DO  - 10.11648/j.ijcoms.20200602.17
    T2  - International Journal of Clinical Oral and Maxillofacial Surgery
    JF  - International Journal of Clinical Oral and Maxillofacial Surgery
    JO  - International Journal of Clinical Oral and Maxillofacial Surgery
    SP  - 56
    EP  - 59
    PB  - Science Publishing Group
    SN  - 2472-1344
    UR  - https://doi.org/10.11648/j.ijcoms.20200602.17
    AB  - Introduction: A tooth that is unable to erupt completely due to some physiological barrier is called impaction. The extraction of the impacted mandibular 3rd molar is the most frequent procedure in oral surgery. The removal of 3rd molar is associated with complications like damage to the inferior alveolar nerve which causes paresthesia of the lower lip depending upon the severity of the damage. Objectives: This study assesses the diagnostic efficacy of orthopantomograph in predicting the association between mandibular third molar roots and inferior alveolar canal and its juxtaposition with intra-operative surgical findings. Material and methods: This cross-sectional research was conducted in the department of Oral & Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore, requiring extraction of mandibular third molars surgically. Patients underwent extraction under local anesthesia. The association between M3 and IAC by comparing OPG findings with intra-operative surgical findings was assessed by chi-square analysis. Results: One hundred and twenty patients requiring mandibular third molar extraction were included in the study. The age of the patients involved in the study ranged from 21-70 years. There were 5 cases of nerve injury in the age group of 31-40 and 1 case in each age group of 21-30 and 41-50. Conclusion: The chances of nerve damage also increase significantly when there is more than one radiographic sign present and the tooth is deeply placed in the mandible nearest to the IAN.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Oral and Maxillofacial Surgery, King Edward Medical University, Lahore, Pakistan

  • Department of Oral and Maxillofacial Surgery, Allied Hospital, Faisalabad, Pakistan

  • Oral and Maxillofacial Surgery, Allied Hospital, Faisalabad, Pakistan

  • Department of Oral and Maxillofacial Surgery CMH, Medical and Dental College, Lahore, Pakistan

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