Sensitivity and specificity of pantomography to predict inferior alveolar nerve damage during extraction of impacted lower third molars.
OBJECTIVE
The purpose of the study was to assess the sensitivity and specificity of maxillary radiographic image findings in predicting nerve lesions in third molar surgery.


METHODS
A total of 260 third molars were assessed prior to surgical removal by means of panoramic radiography in the sample of 153 patients (73.8% female). The tooth root was classified according to the presence or absence of a radiological sign of a close relationship with the mandibular canal. Of the 260 cases assessed, the presence of a radiological sign of a close relationship with the mandibular canal was recorded in 159 cases.


RESULTS
Of the 260 cases, 9 (3.5%) presented postsurgical sensory complications. Though this percentage was higher among those in which there was judged to be a radiological sign of a close relationship with the mandibular canal than in those without such a sign, no significant association was shown to exist between the presence of the radiological sign and postsurgical changes in the inferior alveolar nerve (P = .94). The positive and negative predictive values were 0.03 and 0.97, respectively. Calculations on the results of the radiological examination in relation to the frequency of nerve lesions yielded values of 66% for sensitivity and 39% for specificity.


CONCLUSIONS
Panoramic radiography does not provide the reliable images required for predicting nerve lesions in third molar surgery.
Gomes
Ana Cláudia Amorim
AC
Department of Oral and Maxillofacial Surgery, Pernambuco School of Dentistry, University of Pernambuco, Recife, Brazil.
Vasconcelos
Belmiro Cavalcanti do Egito
BC
Silva
Emanuel Dias de Oliveira
ED
Caldas
Arnaldo de França
Ade F
Pita Neto
Ivo Cavalcante
IC
D000328:Adult; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging*; D008964:Molar, Third / Q000601:surgery*; D011862:Radiography, Panoramic / Q000379:methods*; D014081:Tooth Extraction / Q000009:adverse effects*; D014092:Tooth Root / Q000000981:diagnostic imaging; D014095:Tooth, Impacted / Q000601:surgery*; D061221:Trigeminal Nerve Injuries