The presurgical workup before third molar surgery: how much is enough?
OBJECTIVE
We sought to assess the indications for patient referral for computed tomography (CT) scan before third molar extraction. The influence of the data obtained from the CT scans on the surgical outcome and morbidity was also evaluated.


METHODS
There were 189 patients in the study (120 females and 69 males). Sixty-five patients were referred to receive CT and formed the study group. The remaining patients were included in the control group.


RESULTS
There were no statistically significant differences between the groups with regard to demographic data and tooth and root angulations. Indications for tooth extraction such as pain, swelling, pericoronitis, caries, endodontic problems, pathology, and prosthetic considerations were similar. The proximity of the tooth root to the inferior alveolar canal was the only statistically significant difference between the 2 groups (P <.001). The treatment plan outcomes for extraction, surgical extraction, and follow-up were comparable. The surgeon changed the initial decision from "surgical extraction" to "follow-up" in only 1 case after CT scan.


CONCLUSIONS
Within the limits of the present study, it can be concluded that the main reason for CT scan referral is the proximity of the third molar root to the inferior alveolar canal (<1 mm). The data obtained from the CT scan had minimal effect on the final surgical outcome. The routine use of CT scan in cases of third molar extractions cannot be recommended.
Better
Hadar
H
Oral and Maxillofacial Surgery Unit, Tel Aviv Sourasky Medical Center, Israel.
Abramovitz
Itzhak
I
Shlomi
Biniamin
B
Kahn
Adrian
A
Levy
Yaakov
Y
Shaham
Amit
A
Chaushu
Gavriel
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000601:surgery*; D010347:Patient Care Planning / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000592:standards*; D011446:Prospective Studies; D011861:Radiography, Dental / Q000295:instrumentation / Q000379:methods; D012017:Referral and Consultation / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014081:Tooth Extraction / Q000379:methods* / Q000592:standards