Mandibular canal-related parameters interpreted in panoramic images and CBCT of mandibular third molars as risk factors to predict sensory disturbances of the inferior alveolar nerve

TY - JOUR

T1 - Mandibular canal-related parameters interpreted in panoramic images and CBCT of mandibular third molars as risk factors to predict sensory disturbances of the inferior alveolar nerve

AU - Matzen, L. H.

AU - Petersen, L. B.

AU - Schropp, L.

AU - Wenzel, A.

PY - 2019

Y1 - 2019

N2 - The aim of this study was to determine whether cone beam computed tomography (CBCT) before mandibular third molar removal can improve the risk assessment for neurosensory disturbances of the inferior alveolar nerve (IAN) compared to panoramic radiography (PAN). One hundred and six mandibular third molars examined by PAN and CBCT were removed. A temporary sensory disturbance of the IAN was present in 20 cases; a permanent disturbance was found in one case. Three blinded observers assessed radiographic risk factors in PAN and CBCT images. Positive (PPV) and negative (NPV) predictive values and positive (LR+) and negative (LR−) likelihood ratios were calculated for all parameters for all observers. Inter-observer reproducibility was expressed as both the percentage accordance and the kappa-statistic. Generally, the PPV and LR + were the same for PAN and CBCT, and there was good inter-observer reproducibility. The highest PPV and LR + for PAN were found when part of the roots were positioned inferior to the lower white border line of the canal, and for CBCT when the canal was positioned between the roots of the tooth. In conclusion, parameters assessed in PAN and CBCT are not reliable risk factors for neurosensory disturbances of the IAN, and CBCT appears not to improve the risk assessment.

AB - The aim of this study was to determine whether cone beam computed tomography (CBCT) before mandibular third molar removal can improve the risk assessment for neurosensory disturbances of the inferior alveolar nerve (IAN) compared to panoramic radiography (PAN). One hundred and six mandibular third molars examined by PAN and CBCT were removed. A temporary sensory disturbance of the IAN was present in 20 cases; a permanent disturbance was found in one case. Three blinded observers assessed radiographic risk factors in PAN and CBCT images. Positive (PPV) and negative (NPV) predictive values and positive (LR+) and negative (LR−) likelihood ratios were calculated for all parameters for all observers. Inter-observer reproducibility was expressed as both the percentage accordance and the kappa-statistic. Generally, the PPV and LR + were the same for PAN and CBCT, and there was good inter-observer reproducibility. The highest PPV and LR + for PAN were found when part of the roots were positioned inferior to the lower white border line of the canal, and for CBCT when the canal was positioned between the roots of the tooth. In conclusion, parameters assessed in PAN and CBCT are not reliable risk factors for neurosensory disturbances of the IAN, and CBCT appears not to improve the risk assessment.

KW - cone beam computed tomography

KW - panoramic imaging

KW - radiography

KW - third molar

UR - http://www.scopus.com/inward/record.url?scp=85063790403&partnerID=8YFLogxK

U2 - 10.1016/j.ijom.2019.03.898

DO - 10.1016/j.ijom.2019.03.898

M3 - Journal article

C2 - 30975577

AN - SCOPUS:85063790403

SN - 0901-5027

VL - 48

SP - 1094

EP - 1101

JO - International Journal of Oral and Maxillofacial Surgery

JF - International Journal of Oral and Maxillofacial Surgery

IS - 8

ER -