The Ability of Panoramic Radiography in Determining the Relationship of Mandibular Third Molar Roots with the Inferior Alveolar Canal

Moshfeghi, Mahkameh; Ghaznavi , Aysan; Mohseni , Mojtaba; Nikneshan, Sima

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Volume 25, Issue 4 (10-2013)

J Iran Dent Assoc 2013, 25(4): 214-218

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The Ability of Panoramic Radiography in Determining the Relationship of Mandibular Third Molar Roots with the Inferior Alveolar Canal

Mahkameh Moshfeghi¹, Aysan Ghaznavi², Mojtaba Mohseni³, Sima Nikneshan ^*⁴

1- Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Resident, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3- Dentist
4- Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran , sima_nikneshan@yahoo.com

Abstract: (9524 Views)

Background and Aim: Panoramic radiography is the preoperative imaging technique of choice for impacted mandibular third molar surgery. However, controversy exists regarding the ability of panoramic radiography in determining the relationship of the mandibular third molar roots with the inferior alveolar canal. This study aimed to assess the ability of panoramic radiography in determining the relationship of mandibular third molar roots with the inferior alveolar nerve (IAN) canal .

Materials and Methods : This diagnostic accuracy study was conducted on 100 panoramic radiographs that were evaluated by 5 oral and maxillofacial surgery residents. They offered their expert opinion on the relationship of third molars with the IAN canal based on panoramic radiographs. These perspectives were compared with the actual post-surgical findings. Kappa and weighted Kappa reproducibility tests were used for data analysis .

Results: Among 100 understudy cases, physical contact between the mandibular third molar roots and the canal was not observed in 88 cases intra-operatively while this relationship existed in 12 cases. The panoramic radiography had a diagnostic sensitivity of 83.3%, specificity of 83%, positive predictive value of 40% and negative predictive value of 97.3%. The overall accuracy was 85%. Kappa and weighted Kappa coefficients of reproducibility were 61% and 79%, respectively .

Conclusion: Panoramic radiography can be confidently used as the most reliable and commonly accessible imaging technique. Considering the obtained negative predictive value, panoramic radiography is capable of revealing the involvement of third molar roots with the IAN canal with 97.3% accuracy. Panoramic radiography had a low diagnostic value in determining the morphology of roots .

Keywords: Panoramic radiography, inferior alveolar nerve, third molar

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Type of Study: Original | Subject: Oral and Maxillofacial Radiology

References

1. Peterson LJ, Hupp J, Ellis E, Tucker M, Editor. Contemporary oral and maxillofacial surger. 5thed. Canada: Mosby, Elsevier; 2008, 160.

2. Bell GW, Rodgers JM, Grime RJ, Edwards Kl, Hahn MR, Dorman ML, et al. The accuracy of dental panoramic tomography in determining the root morphology of mandibular third molar teeth before surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Jan;95(1):119-25.

3. Smith AC, Barry SE, Chiong AY, Hadzakis DIKha SL, Mok SC, Sable DL. Inferior alveolar nerve damage following removal of mandibular third molar teeth. A prospective study using panoramic radiography. Aust Dent J. 1997 Jun; 42(3): 149-152.

4. Dalili ZA, Mahjoub P, Khalighi Sigaroudi A. Comparison between cone beam computed to-mography and panoramic radiography in the assessment of the relationship between the mandibular canal and impacted class C man-dibular third molars. Dent Res J. (Isfahan) 2011Oct-Dec;8(4):203-210. (Persian)

5. Tammisalo T, Happonen RP, Tammisalo EH. Stereographic assessment of mandibular canal in relation to the roots of impacted lower third molar using multi projection narrow beam radi-ography. Int J Oral Maxillofac Surg. 1992 Apr; 21(2):85-89.

6. Szalma J, Lempel E, Jeges S, Olasz L. Darken-ing of third molar roots: Panoramic radiographic associations with inferior alveolar nerve expo-sure. J Maxillofac Oral Surg. 2011 Jun;69(6):1544-9.

7. Ezoddini Ardakani F, Zangouie Booshehri M, Navab A, Fotoohi Ardakani F: Diagnostic accu-racy of panoramic radiography in determining the Position of impacted third molars in relation to the inferior dental canal compared with sur-gery. Iran J Radiol. 2010 July;7(2):91-96. (Per-sian)

8. Gupta S, Bhowate RR, Nigam N, Saxena S: Evaluation of impacted mandibular third molars by panoramic radiography. ISRN Dent. 2011 Sep; 5 (1):1-8.

9. Atieh MA. Diagnostic accuracy of panoramic radiography in determining relationship between inferior alveolar nerve and mandibular third molar. J Maxillofac Oral Surg. 2010 Jan;68(1):74-82.

10. Nakagawa Y, Ishii H, Nomura Y, Watanabe NY, Hoshiba D, Kobayashi, Ishibashi K. Third molar position: Reliability of panoramic radiog-raphy. J Oral Maxillofac Surg. 2007 Jul; 65(7): 1303-8.

11. Blaeser BF, August MA, Donoff RB, Kaban LB, Dodson TB. Panoramic radiographic risk factors for inferior alveolar nerve injury after third molar extraction. J Maxillofac Oral Surg. 2003 Apr; 61(4):417-21.

12. Koong B, Pharoah MJ, Bulsara M, Tennant M. Methods of determining the relationship of the mandibular canal and third molars. Aust Dent J. 2006 Mar;51(1):64-8.

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Moshfeghi M, Ghaznavi A, Mohseni M, Nikneshan S. The Ability of Panoramic Radiography in Determining the Relationship of Mandibular Third Molar Roots with the Inferior Alveolar Canal. J Iran Dent Assoc 2013; 25 (4) :214-218
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Volume 25, Issue 4 (10-2013)

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