Classification of Impacted Mandibular Third Molar Utilizing Cone Beam Computed Tomography in Saudi Arabia 2024

Abstract

Background:A radiographic examination of mandibular third molars is meant to support the surgeon in establishing a treatment plan. Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbors the inferior alveolar nerve, can be clearly identified on CBCT. This study aimed: To assess the relationship between an impacted third molar and mandibular canal on cone beam CT (CBCT) images.Methods: In order to create a categorization that could explain every potential association between the third molar and IAN on the cross-sectional images, three members of the surgical team independently examined the CBCT images of 80 individuals (133 mandibular third molars). The study population was then split up based on this classification. The statistical analysis was conducted using SPSS software, version 28.0.Results: Six classes (classes 1-6) were further separated into two subtypes (subtypes A-B), out of the eight proposed classes (classes 0-7). The distribution of classes revealed that the mandibular canal's buccal or apical path was more common than its lingual and inter-radicular courses. Apart from a higher likelihood of actual contact without corticalization of the canal when the IAN had a lingual course for the female group, there have been no changes in the anatomical relationships between males and females. Younger individuals had a higher frequency of direct contact without corticalization and/or with a lower canal diameter.Conclusion: In practical practice, this classification could be a useful tool for establishing a standard language across operators to describe the potential connections between the mandibular canal and an impacted third molar on CBCT pictures.