Patterns of Impacted Third Molars and Their Proximity to Vital Structures
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Author:
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DR.SUBHASHINI R, DR. ABDUL WAHAB P U, DR. SANTHOSH KUMAR M P
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Abstract:
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The surgical removal of impacted third molars is one of the most common procedures in Oral and Maxillofacial Surgery. It can be complicated by Inferior Alveolar Nerve (IAN) damage while removal of mandibular third molars or by perforation of maxillary sinus during removal of maxillary third molars. The aim of this study was to evaluate the relationship between Impacted Mandibular third molars and Impacted Maxillary third molars to Inferior Alveolar Nerve and Maxillary Sinus respectively. Pre operative orthopantomographs (OPGs) were retrieved from hospital computer case records and relationships between impacted third molars to vital structures were analysed. Totally 683 OPGs of patients who underwent surgery for impacted third molars were retrieved. Out of 683 OPGs, 598 had impacted mandibular third molars and 85 had impacted maxillary third molar. The roots of mandibular third molars and the nerve canal were categorised as per Rood and Shehab criteria. The relationship of maxillary impacted third molar and maxillary sinus was categorised into (i) Sinus Approximation (ii) No Sinus Approximation. Out of 598 Impacted mandibular third molars, 206 (34.4%) were in proximity to the inferior alveolar nerve canal. Among impacted mandibular third molars, 13% of OPG showed Darkening of roots, 8.9% showed Interruption of White line of canal followed by Narrowing of roots (5.9%) and no relation (64.9%). Out of 85 Impacted Maxillary third molar, 29 (34%) had Sinus approximation and the results were statistically significant (p=0.03). The relationship between impacted third molars and its proximity to vital structures is important and it should be considered during surgical removal of the teeth. When a risk of nerve damage or Sinus perforation is predicted in an extraction, a presurgical cone beam computed tomography could be of immense value.
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Keyword:
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Impacted third molar, inferior alveolar nerve; maxillary sinus; orthopantomograph; patterns
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EOI:
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-
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DOI:
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https://doi.org/10.31838/ijpr/2020.SP2.289
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