ÜÇÜNCÜ MOLAR DİŞLERİN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİ (CBCT) İLE DEĞERLENDİRİLMESİ

Yıl 2021, Cilt: 8 Sayı: 1, 1 - 7, 30.04.2021

Gaye Keser , Emre Ergun , Filiz Namdar Pekiner

https://doi.org/10.15311/selcukdentj.776842

Öz

ÖZ

Amaç: Bu çalışmanın amacı, Konik Işınlı BT (CBCT) görüntülerde gömük üçüncü molar ve mandibular kanal arasındaki ilişkiyi değerlendirmek için klinik uygulamada kullanılabilen yeni bir radyolojik sınıflandırmayı tanıtmaktır.
Gereç ve Yöntemler: Çalışmada üçüncü molar dişlerin mandibular kanal ile olan ilişkileri, üçüncü molar dişin inferior alveolar kanala olan uzaklığı, kanalın dişe göre bukkal-apikal-lingual pozisyonu, kanal ile üçüncü molar dişlerin arasında temas olup olmaması gibi kriterler göz önünde bulundurularak yapılan sınıflamaya göre değerlendirilmiştir. Bu kriterlere göre 0 (sıfır) ile 7 arasında toplam sekiz adet ve “A ve B” olmak üzere iki adet alt grup ile sınıflandırma yapılmıştır. 50 hastanın CBCT görüntüleri kesitsel görüntülerde üçüncü molar ile madibular kanal arasındaki muhtemel tüm ilişkiler bağımsız bir şekilde incelenmiştir. Daha sonra, çalışma populasyonu bu sınıflamaya göre alt bölümlere ayrılmıştır. İstatistiksel analiz için SPSS 24.0 sürümü kullanılmıştır.
Bulgular: Alt sol üçüncü molar dişlerde (38) cinsiyete dayalı değerlendirmede en sık görülen sınıfın 1A (% 48,6) olduğu bulgulanmıştır. Her iki cinsiyette en sık görülen 1A sınıfı kadınlarda % 23 ve erkeklerde % 23,4 olmuştur. Sağ alttaki üçüncü molar dişler için (48), en yaygın sınıfın cinsiyete bakılmaksızın 1A (% 45) olduğu tespit edilmiştir.
Sonuç: Bu sınıflamanın kullanımı, üçüncü molar ile mandibular kanal arasındaki olası ilişkileri CBCT görüntüleri üzerinde tanımlamada operatörler arasında ortak bir dil elde etmek için klinik pratikte geçerli bir yöntem olabilmektedir.

Anahtar Kelimeler

Konik ışınlı bilgisayarlı tomografi,, üçüncü molar,, mandibular kanal,

Evaluation of the association between mandibular canal and mandibular third molars on cone beam computerized tomography (CBCT)

Öz

Background: The aim of this study was to introduce a new radiological classification that could be normally used in clinical practice to assess the relationship between an impacted third molar and mandibular canal on cone beam CT (CBCT) images.
Material and Methods: The relationship between the third molar teeth and the mandibular canal, the distance of the third molar to the inferior alveolar canal, buccal-apical-lingual position of the canal relative to the tooth, and the presence of contact between the canal and the third molar teeth were evaluated according to the classification. According to these criteria, a total of eight classifications and two subtypes , class A and B, were made. CBCT images of 50 patients were independently studied all the possible relationships between third molar and IAN on the cross-sectional images. The SPSS software version 24.0 was used for the statistical analysis.
Results: For the lower left third molar teeth (38), it was found to be that the most common class was 1A (48,6%) in gender-free examination. For the third molar teeth (48) in the lower right mandibula, it was found to be that the most common class was 1A (45%) regardless of the gender.
Conclusion: The use of this classification could be a valid support in clinical practice to obtain a common language among operators in order to define the possible relationships between an impacted third molar and the mandibular canal on CBCT images.

Anahtar Kelimeler

Cone Beam computed tomography,, third molar,, mandibular canal,

Kaynakça

• 1.Castro MAA, Lagravere-Vich MO, Amaral TMP, Abreu MHG, Mesquita RA. Classification of mandibular canal branching: Areview of literature. World Journal of Radiology 2015:531-2.
• 2. Libersa P, Savignat M, Tonnel A. Neurosensory disturbances of the inferior alveolar nerve: retrospective study of complaints in a 10-year period. J Oral Maxillofac Surg 2007.;65(8):1486-89.
• 3. Peker İ, Sarikir C, Alkurt MT, Zor ZF. Panoramic radiography and cone-beam computed tomography findings in preoperative examination of impacted mandibular third molars. BMC Oral Health 2014; 14;14:71.
• 4. Mukherjee S, Vikraman B, Sankar D, Veerabahu MS. Evaluation of Outcome Following Coronectomy for the Management of Mandibular Third Molars in Close Proximity to Inferior Alveolar Nerve. Journal of Clinical and Diagnostic Research 2016; 10(8):ZC57-62.
• 5. Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques of the inferior alveolar nerve (IAN): a narrative review. Surg Radiol Anat 2016;38(1):55-63.
• 6. Rood JP, Shehab BAAN. The radiological prediction of inferior alveolar nerve injury during third molar surgery. British Journal of Oral & Maxillofaical Surgery 1990;28(1):20-5.
• 7.Jung Y-H, Nah K-S, Cho B-H. Correlation of panoramic radiographs and cone beam computed tomography in the assessment of superimposed relationship between the mandibular canal and impacted third molars. Imaging Science in Dentistry 2012;42(3):121-7.
• 8.Aktan AM, Güngör E, Çiftçi ME. Diş Hekimliğinde Konik Işınlı Bilgisayarlı Tomografi Kullanımı. Atatürk Üniv Diş Hek Fak Derg 2015 ;25: 71-76.
• 9. Mayil M., Keser G., Pekiner FN. CBCT Images of anatomic landmarks in maxillofacial region. CEHS 2014;4:232-240.
• 10.Carter L, Farman AG, Geist J, Scarfe WC, Angelopoulos C et al. American Academy of Oral Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:561-2.
• 11.Razavi T, Palmer RD, Davies J, Wilson R, Palmer PJ. Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography. Clin Oral Implants Res. 2010;23:718-725.
• 12. Adibi S, Zhang W, Servos T, O’Neill PN. Cone Beam Computed Tomography in Dentistry: What Dental Educators and Learners Should Know. J Dent Educ. 2009; 76:1437--42.
• 13. Maglione M, Costantinides F, Bazzocchi G. Classification of impacted mandibular third molars on cone-beam CT images. J Clin Exp Dent 2015:e224-231.
• 14. Arora A, Patil B, Sodhi A. Validity of vertical tube shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal. J Korean Assoc Oral Maxillofac Surg 2015; 41(2):66-73.
• 15.Almendros-Marquez N, Berini-Aytes L, Gay-Escoda C. Evaluation of intraexaminer and interexaminer agreement on classifying lower third molars according tothe system of Pell and Gregory and Winter. J Oral Maxillofac Surg 2008; 66(5):893-9.
• 16. Tantanapornkul W, Okochi K, Bhakdinaronk A, Ohbayashi N, Kurabayashi T. Correlation of darkening of impacted mandibular third molar root on digital panoramic images with cone beam computed tomography findings. The British Institute of Radiology 2009. 38(1):11-6.
• 17. Nakamori K, Tomihara K, Noguchi M. Clinical significance of computed tomography assessment for third molar surgery. World Journal of Radiology 2014;6(7):417-423.
• 18. Soumalainen A, Venta I, Mattila M, Turtola L, Vehmas T, Peltola JS. Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109(2):276-284.
• 19. Lee B, Park Y, Ahn J, Chun J, Park S, Kim M, et al. Assessment of the proximity between the mandibular third molar and inferior alveolar canal using preoperative 3D-CT to prevent inferior alveolar nerve damage. Maxillofacial Plastic and Reconsturctive Surgery 2015; 37(1):30.
• 20. Jhamb A, Dolas RS, Pandilwar PK. Comparative efficacyof spiral computed tomography and orthopantomography in preoperative detection of relation of inferior alveolar neurovascular bundle to impacted mandibular third molar. J Oral Maxillofac Surg 2009; 67(1):58-66.
• 21. Nakayama K, Nonoyama M, Takaki Y, Kagawa T, Yuasa K, Izumi K, et al. Assessment of the relationship between impacted mandibular third molars and inferior alveolar nerve with dental 3-Dimentional computed tomography. J Oral Maxillofac Surg 2009; 67(12):2587-91.
• 22. Kim H-G, Lee J-H. Analysis and evaluation of relative positions of mandibular third molar and mandibular canal impacts. J Korean Assoc Oral Maxillofac Surg 2014:278-282.
• 23.Ghaeminia H, Meijer GJ, Soehardi A, Borstlap WA, Mulder J, Berge SJ. Position of the impacted third molar in relation to the mandibular canal.Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. J Oral Maxillofac Surg 2009; 38(9):964-971.
• 24. Sammartino G, Wang H, Citarella R, Lepore M, Marenzi G. Analysis of occlusal stresses transmitted to the inferior alveolar nerve by multiple threaded implants. J Periodontol 2013;84(11):1655-61.
• 25.Park W, Choi J, Kim Y, Kim H, Lee S. Cortical integrity of the inferior alveolar canal as a predictor of parasthesia after third-molar extraction. J Am Dent Assoc 2010; 141(3):271-8.