A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars.
OBJECTIVE
To evaluate the diagnostic accuracy of cone-beam CT compared with panoramic images in predicting neurovascular bundle exposure during extraction of impacted mandibular third molars.


METHODS
Cone-beam CT and panoramic images of 142 impacted mandibular third molars were prospectively evaluated to assess tooth relationship to the mandibular canal. These interpretations were then correlated with intraoperative findings. The sensitivity and specificity of the 2 modalities in predicting neurovascular bundle exposure at extraction were calculated and compared. The diagnostic criterion for panoramic images was defined using multivariate logistic regression analysis.


RESULTS
In predicting the exposure, the sensitivity and specificity were 93% and 77% for cone-beam CT, and 70% and 63% for panoramic images, respectively. Cone-beam CT was significantly superior to panoramic images in both sensitivity and specificity.


CONCLUSIONS
Cone-beam CT was significantly superior to panoramic images in predicting neurovascular bundle exposure during extraction of impacted mandibular third molar teeth.
Tantanapornkul
Weeraya
W
Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Okouchi
Kiyoshi
K
Fujiwara
Yoshikuni
Y
Yamashiro
Masashi
M
Maruoka
Yutaka
Y
Ohbayashi
Naoto
N
Kurabayashi
Tohru
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D008964:Molar, Third / Q000000981:diagnostic imaging* / Q000601:surgery; D015999:Multivariate Analysis; D010292:Paresthesia / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011861:Radiography, Dental / Q000379:methods*; D011862:Radiography, Panoramic; D014057:Tomography, X-Ray Computed / Q000379:methods; D014081:Tooth Extraction / Q000009:adverse effects; D014095:Tooth, Impacted / Q000000981:diagnostic imaging* / Q000601:surgery