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Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 6-16

Can a panoramic radiograph predict the inferior alveolar nerve canal's position, or canal compression, near third molar root apices?

1 Department of Oral and Maxillofacial Surgery, Walter Reed National Military Medical Center, Bethesda, MD, North Chicago, IL, USA
2 Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA

Correspondence Address:
Peter D Cervenka
Naval Medical Center Portsmouth, Naval Dental Clinic Norfolk, 1647 Admiral Taussig Blvd., BLDG. CD3, 2nd Flr, Room 260, Norfolk, VA 23511
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jomr.jomr_4_21

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Background: Injury to the inferior alveolar nerve can occur during surgical removal of the mandibular third molars (M3Ms), resulting in numbness of the mandibular teeth, chin, and lower lip. This occurs when the roots of M3M compress the inferior alveolar canal (IAC) against the lingual cortical plate. Cone-beam computed tomography (CBCT) reveals the buccolingual relationship of the IAC and M3M, but the panoramic radiograph (PR) has not been evaluated to determine whether the plane film can reveal this relationship. Aims: The aim of the study is to determine whether PR could predict buccal or lingual IAC position or compression near M3M. Design: This retrospective study evaluated 200 M3M sites in 42 women and 67 men, aged 17–28 years. Ninety-one bilateral measurements were taken; 98 left and 102 right halves were analyzed. Methods: IAC position and degree of compression were interpreted from the CBCT. Utilizing imaging software, 13 different measurements were obtained. Statistical Analyses: Fisher's exact test, t-test, principal component analysis, and multivariate analysis were utilized. Results: Male and female canal positions significantly differed. Canal position was significantly different comparing partially erupted to erupted and fully bony impacted molars. Lingual canal position, versus buccal, was more frequently associated with moderate-to-severe IAC compression. “Anterior-posterior ramus at the occlusal plane” and “anterior ramus to anterior IAC at the occlusal plane” contributed most to the severity of IAC compression. Conclusion: The variables evaluated did not identify a significant relationship. A larger data set is needed to evaluate any role the dimension of the ramus has on IAC compression.

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