Publication: Hallazgos radiológicos en la evaluación prequirúrgica de la exodoncia del tercer molar inferior: estudio comparativo entre la radiografía panorámica y el CBCT
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2016-04-19
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Universidad Complutense de Madrid
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Abstract
Introducción La evaluación prequirúrgica de la exodoncia del tercer molar inferior se basa fundamentalmente en la radiografía panorámica. Únicamente en aquellos casos en los que se aprecian en ella signos de relación con el nervio dentario inferior se acude a un estudio adicional como el CBCT para clarificar dicha relación. Objetivos 1º.- Determinar la posición y situación del tercer molar que con mayor frecuencia se han encontrado. 2º.- Valorar la posición del nervio dentario inferior respecto al tercer molar. 3º.- Establecer el signo radiológico de relación más frecuente entre el tercer molar y el conducto dentario. 4º.- Evaluar la frecuencia de asociación entre los diferentes signos radiológicos de relación. 5º.- Comprobar si el patrón de crecimiento mandibular influye en las diferentes situaciones estudiadas. 6º.- Verificar la correlación entre la radiografía panorámica y el CBCT. Material y metodología: Estudio retrospectivo sobre 400 pacientes del servicio de Radiología de la Facultad de Odontología UCM con un CBCT mandibular que en la reconstrucción panorámica cuenten con un tercer molar inferior que presente oscurecimiento de raíces, desviación del conducto dentario, desviación de raíces o pérdida de cortical del conducto. Sobre ellos se estudiaron diversas variables demográficas así como se clasificaron las diferentes situaciones empleando la clasificación propuesta por Tanaka y cols. en 2000. Del mismo modo se recogió el ángulo mandibular para determinar el patrón de crecimiento...
BACKGROUND The extraction of the lower third molars is the most frequent activity of oral surgery. To avoid or reduce potential injury to the inferior alveolar nerve, is critical preoperative radiological study based essentially on the panoramic radiography. In 1990 Rood described a series of radiological signs that increase the risk of alveolar nerve injury during extraction of lower third molars. The CBCT has shown that establishes the relationship between the third molar and mandibular canal better than dental panoramic radiography. We think that a study linking the different situations present in the panoramic radiography and the CBCT in the preoperative radiological study of the lower third molars at high risk of nerve injury, can help to take the decision against removal. HYPOTHESIS AND OBJETIVES If we admit that the signs of relationship between the mandibular canal and the lower third molar can predict the possible nerve damage, the CBCT is useful to reduce injury cases, and that sex or pattern of mandibular growth of the patient can influence this relationship might be able to describe situations in which the request for this additional exploration is justified in terms of radiological findings found. 1.- Determine the position and status of third molar that most often found in the present study. 2.- To assess the position of the inferior alveolar nerve from the third molar, evaluating the surgical risk. 3.- Set the most frequent radiological sign of relationship between the third molar and the mandibular canal. 4.- To evaluate the frequency of association between different radiographic signs of relationship. 5.- Check mandibular growth pattern influences the situation of the third molar, position or different possible relationships between this and the mandibular canal. 6.- Check if the radiological findings in the panoramic radiograph is consistent with what is reflected in the CBCT...
BACKGROUND The extraction of the lower third molars is the most frequent activity of oral surgery. To avoid or reduce potential injury to the inferior alveolar nerve, is critical preoperative radiological study based essentially on the panoramic radiography. In 1990 Rood described a series of radiological signs that increase the risk of alveolar nerve injury during extraction of lower third molars. The CBCT has shown that establishes the relationship between the third molar and mandibular canal better than dental panoramic radiography. We think that a study linking the different situations present in the panoramic radiography and the CBCT in the preoperative radiological study of the lower third molars at high risk of nerve injury, can help to take the decision against removal. HYPOTHESIS AND OBJETIVES If we admit that the signs of relationship between the mandibular canal and the lower third molar can predict the possible nerve damage, the CBCT is useful to reduce injury cases, and that sex or pattern of mandibular growth of the patient can influence this relationship might be able to describe situations in which the request for this additional exploration is justified in terms of radiological findings found. 1.- Determine the position and status of third molar that most often found in the present study. 2.- To assess the position of the inferior alveolar nerve from the third molar, evaluating the surgical risk. 3.- Set the most frequent radiological sign of relationship between the third molar and the mandibular canal. 4.- To evaluate the frequency of association between different radiographic signs of relationship. 5.- Check mandibular growth pattern influences the situation of the third molar, position or different possible relationships between this and the mandibular canal. 6.- Check if the radiological findings in the panoramic radiograph is consistent with what is reflected in the CBCT...
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Tesis inédita de la Universidad Complutense de Madrid de la Facultad de Odontología del Departamento de Estomatología III, leída el 11-12-2015