Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 4/2013

01-05-2013 | Original Article

Correlation of mandibular impacted tooth and bone morphology determined by cone beam computed topography on a premise of third molar operation

Authors: M. A. Momin, K. Matsumoto, K. Ejima, R. Asaumi, T. Kawai, Y. Arai, K. Honda, T. Yosue

Published in: Surgical and Radiologic Anatomy | Issue 4/2013

Login to get access

Abstract

Purpose

To determine the width and morphology of the mandible in the impacted third molar region, and to identify the location of the mandibular canal prior to planning impacted third molar operations.

Methods

Cone beam computed tomography (CBCT) data of 87 mandibular third molars from 62 Japanese patients were analyzed in this study. The width of the lingual cortical bone and apex-canal distance were measured from cross-sectional images in which the cortical bone was thinnest at the lingual side in the third molar region. Images were used for measuring the space (distance between the inner border of the lingual cortical bone and outer surface of the third molar root), apex-canal distance (distance from the root of the third molar tooth to the superior border of the inferior alveolar canal) and the cortical bone (width between the inner and outer borders of the lingual cortical bone).

Results

The means of the space, apex-canal distance and lingual cortical width were 0.31, 1.99, and 0.68 mm, respectively. Impacted third molar teeth (types A–C) were observed at the following frequencies: type A (angular) 37 %; type B (horizontal), 42 %; type C (vertical), 21 %. The morphology of the mandible at the third molar region (types D–F) was observed as: type D (round), 49 %; type E (lingual extended), 18 %; and type F (lingual concave), 32 %.

Conclusions

The width and morphology of the mandible with impacted teeth and the location of the mandibular canal at the third molar region could be clearly determined using cross-sectional CBCT images.
Literature
1.
go back to reference Araki K, Maki K, Seki K, Sakamaki K, Harata Y, sakaino R, Okano T, Seo K (2004) Characteristics of a newly developed dentomaxillofacial X-ray cone beam CT scanner: system configuration and physical properties. Dentomaxillofac Radiol 33:51–59PubMedCrossRef Araki K, Maki K, Seki K, Sakamaki K, Harata Y, sakaino R, Okano T, Seo K (2004) Characteristics of a newly developed dentomaxillofacial X-ray cone beam CT scanner: system configuration and physical properties. Dentomaxillofac Radiol 33:51–59PubMedCrossRef
2.
go back to reference Suomalainen A, Ventä I, Mattila M, Turtola L, Vehmas T, Peltola JS (2010) Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:276–284PubMedCrossRef Suomalainen A, Ventä I, Mattila M, Turtola L, Vehmas T, Peltola JS (2010) Reliability of CBCT and other radiographic methods in preoperative evaluation of lower third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:276–284PubMedCrossRef
3.
go back to reference Bataineh AB (2001) Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 59:1012–1017PubMedCrossRef Bataineh AB (2001) Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 59:1012–1017PubMedCrossRef
4.
go back to reference Better H, Abramowitz I, Shlomi B, Kahn A, Levy Y, Shaham A, Chaushu G (2004) The presurgical workup before third molar surgery: how much is enough? J Oral Maxillofac Surg 62:689–692PubMedCrossRef Better H, Abramowitz I, Shlomi B, Kahn A, Levy Y, Shaham A, Chaushu G (2004) The presurgical workup before third molar surgery: how much is enough? J Oral Maxillofac Surg 62:689–692PubMedCrossRef
5.
go back to reference Brann CR, Brickley MR, Shepherd JP (1999) Factors influencing nerve damage during lower third molar surgery. Br Dent J 186:514PubMed Brann CR, Brickley MR, Shepherd JP (1999) Factors influencing nerve damage during lower third molar surgery. Br Dent J 186:514PubMed
6.
go back to reference Blaeser BF, August MA, Donoff RB, Kaban LB, Dodson TB (2003) Panoramic radiographic risk factors for inferior alveolar nerve injury after third molar extraction. J Oral Maxillofac Surg 61:417–421PubMedCrossRef Blaeser BF, August MA, Donoff RB, Kaban LB, Dodson TB (2003) Panoramic radiographic risk factors for inferior alveolar nerve injury after third molar extraction. J Oral Maxillofac Surg 61:417–421PubMedCrossRef
7.
go back to reference Carmichael FA, McGowan DA (1992) Incidences of nerve damage following third molar removal: a west of Scotland oral surgery research group study. Br J Oral Maxillofac Surg 30:78–82PubMedCrossRef Carmichael FA, McGowan DA (1992) Incidences of nerve damage following third molar removal: a west of Scotland oral surgery research group study. Br J Oral Maxillofac Surg 30:78–82PubMedCrossRef
8.
go back to reference Chiapasco M, De Cicco L, Marrone G (1993) Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol 76(4):412–420PubMedCrossRef Chiapasco M, De Cicco L, Marrone G (1993) Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol 76(4):412–420PubMedCrossRef
9.
go back to reference Roeder Felix, Wachtlin Daniel, Schulze Ralf (2011) Necessity of 3D visualization for the removal of lower wisdom teeth: required sample size to prove non-inferiority of panoramic radiography compared to CBCT. Clin Oral Invest. doi:10.1007/s00784-011-0553-8 Roeder Felix, Wachtlin Daniel, Schulze Ralf (2011) Necessity of 3D visualization for the removal of lower wisdom teeth: required sample size to prove non-inferiority of panoramic radiography compared to CBCT. Clin Oral Invest. doi:10.​1007/​s00784-011-0553-8
10.
go back to reference Feifel H, Riediger G, Gustorf-Aecerle R (1994) High resolution computed tomography of the inferior alveolar and lingual nerves. Neuroradiology 36:236–245PubMedCrossRef Feifel H, Riediger G, Gustorf-Aecerle R (1994) High resolution computed tomography of the inferior alveolar and lingual nerves. Neuroradiology 36:236–245PubMedCrossRef
11.
go back to reference Howe EL, Poyton HE (1960) Prevention of damage to the inferior dental nerve during the extraction of mandibular third molars. Br Dent J 109:355–363 Howe EL, Poyton HE (1960) Prevention of damage to the inferior dental nerve during the extraction of mandibular third molars. Br Dent J 109:355–363
12.
go back to reference Hillerup S (2007) Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Invest 11:133–142CrossRef Hillerup S (2007) Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Invest 11:133–142CrossRef
13.
go back to reference Harris D, Buser D, Dula K, Grondahl K, Harris D, Jacobs R et al (2002) E.A.O. guidelines for the use of diagnostic imaging in implant dentistry. A consensus workshop organized by the European association for Osseointegration in Trinity college Dublin. Clin Oral Impl Res 3:566–570CrossRef Harris D, Buser D, Dula K, Grondahl K, Harris D, Jacobs R et al (2002) E.A.O. guidelines for the use of diagnostic imaging in implant dentistry. A consensus workshop organized by the European association for Osseointegration in Trinity college Dublin. Clin Oral Impl Res 3:566–570CrossRef
14.
go back to reference Heurich T, Ziegler C, Stevrling H, Wortche R, Muhling J, Hassfeld S (2002) Digital volume tomography an extension to the diagnostic procedures available for application before surgical removal of third molars. Mund Kiefer Gesichtschir 6:427–432PubMedCrossRef Heurich T, Ziegler C, Stevrling H, Wortche R, Muhling J, Hassfeld S (2002) Digital volume tomography an extension to the diagnostic procedures available for application before surgical removal of third molars. Mund Kiefer Gesichtschir 6:427–432PubMedCrossRef
15.
go back to reference Honey OB, Scarfe WC, Hilgers MJ, Klueber K, Silveira AM, Haskell BS et al (2007) Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofac Orthop 132:429–438CrossRef Honey OB, Scarfe WC, Hilgers MJ, Klueber K, Silveira AM, Haskell BS et al (2007) Accuracy of cone-beam computed tomography imaging of the temporomandibular joint: comparisons with panoramic radiology and linear tomography. Am J Orthod Dentofac Orthop 132:429–438CrossRef
16.
go back to reference Honda K, Arai Y, Kashima M, Sawada K, Ejima K, Iwai K (2004) Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofac Radiol 33:391–395PubMedCrossRef Honda K, Arai Y, Kashima M, Sawada K, Ejima K, Iwai K (2004) Evaluation of the usefulness of the limited cone-beam CT (3DX) in the assessment of the thickness of the roof of the glenoid fossa of the temporomandibular joint. Dentomaxillofac Radiol 33:391–395PubMedCrossRef
17.
go back to reference Ghaeminia H, Meijer GJ, Soehardi A, Borstlap WA, Mulder J, Berge′ SJ (2009) Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. Int J Oral Maxillofac Surg 38:964–971PubMedCrossRef Ghaeminia H, Meijer GJ, Soehardi A, Borstlap WA, Mulder J, Berge′ SJ (2009) Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. Int J Oral Maxillofac Surg 38:964–971PubMedCrossRef
18.
go back to reference Inaoka SD, Carneiro SC, Vasconcelos BC, Leal J, Porto GG (2009) Relationship between mandibular fracture and impacted lower third molar. Med Oral Patol Oral Cir Bucal 14(7):E349–E354PubMed Inaoka SD, Carneiro SC, Vasconcelos BC, Leal J, Porto GG (2009) Relationship between mandibular fracture and impacted lower third molar. Med Oral Patol Oral Cir Bucal 14(7):E349–E354PubMed
19.
go back to reference Kipp DP, Goldstein BH, Weiss WW Jr (1980) Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1377 surgical procedures. J Am Dent Assoc 100:185–192PubMed Kipp DP, Goldstein BH, Weiss WW Jr (1980) Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1377 surgical procedures. J Am Dent Assoc 100:185–192PubMed
20.
go back to reference Kijima N, Honda K, Kuroki Y, Sakabe J, Ejima K, Nakajima I (2007) Relationship between patient characteristics, mandibular head morphology and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints. Dentomaxillofac Radiol 36:277–281PubMedCrossRef Kijima N, Honda K, Kuroki Y, Sakabe J, Ejima K, Nakajima I (2007) Relationship between patient characteristics, mandibular head morphology and thickness of the roof of the glenoid fossa in symptomatic temporomandibular joints. Dentomaxillofac Radiol 36:277–281PubMedCrossRef
21.
go back to reference Lopes V, Mumenya R, Feinmann C (1995) Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg 33:33–35PubMedCrossRef Lopes V, Mumenya R, Feinmann C (1995) Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg 33:33–35PubMedCrossRef
22.
go back to reference Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB (2006) Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray. NewTom 3G and i-CAT. Dentomaxillofac Radiol 35:219–226PubMedCrossRef Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB (2006) Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray. NewTom 3G and i-CAT. Dentomaxillofac Radiol 35:219–226PubMedCrossRef
23.
go back to reference Flygare L, Öhman A (2008) Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Invest 12:291–302CrossRef Flygare L, Öhman A (2008) Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Invest 12:291–302CrossRef
24.
go back to reference Maegawa H, Sano K, Kitagawa Y, Ogasawara T, Miyauchi K, Sekine J et al (2003) Preoperative assessment of the relationship between the mandibular third molar and the mandibular canal by axial computed tomography with coronal and sagittal reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:639–646PubMedCrossRef Maegawa H, Sano K, Kitagawa Y, Ogasawara T, Miyauchi K, Sekine J et al (2003) Preoperative assessment of the relationship between the mandibular third molar and the mandibular canal by axial computed tomography with coronal and sagittal reconstruction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:639–646PubMedCrossRef
25.
go back to reference Momin MA, Okochi K, Watanabe H, Imaizumi A, Amagasa T, Okada N et al (2009) Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: comparison with conventional panoramic radiography. Eur J Radiol 72:75–81PubMedCrossRef Momin MA, Okochi K, Watanabe H, Imaizumi A, Amagasa T, Okada N et al (2009) Diagnostic accuracy of cone-beam CT in the assessment of mandibular invasion of lower gingival carcinoma: comparison with conventional panoramic radiography. Eur J Radiol 72:75–81PubMedCrossRef
26.
go back to reference Ohman A, Kivijarvi K, Blomback U, Flygare L (2006) Pre-operative radiographic evaluation of lower third molars with computed tomography. Dentomaxillofac Radiol 35:30–35PubMedCrossRef Ohman A, Kivijarvi K, Blomback U, Flygare L (2006) Pre-operative radiographic evaluation of lower third molars with computed tomography. Dentomaxillofac Radiol 35:30–35PubMedCrossRef
27.
go back to reference Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD (2003) Vestibular surgical access to the palatine root of the superior first molar: “low-dose cone beam” CT ankylosis of the pathway and its anatomic variations. J Endod 29:773–775PubMedCrossRef Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD (2003) Vestibular surgical access to the palatine root of the superior first molar: “low-dose cone beam” CT ankylosis of the pathway and its anatomic variations. J Endod 29:773–775PubMedCrossRef
28.
go back to reference Szalma J, Lempel E, Jeges S, Szabo G, Olasz L (2010) The prognostic value of panoramic radiography of inferior nerve damage after mandibular third molar removal: retrospective study of 400 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:294–302PubMedCrossRef Szalma J, Lempel E, Jeges S, Szabo G, Olasz L (2010) The prognostic value of panoramic radiography of inferior nerve damage after mandibular third molar removal: retrospective study of 400 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:294–302PubMedCrossRef
29.
go back to reference Sisk AL, Hammer WB, Shelton DW (1986) Complications following removal of impacted third molars. The role of the experience of the surgeon. J Oral Maxillofac Surg 44:855–859PubMedCrossRef Sisk AL, Hammer WB, Shelton DW (1986) Complications following removal of impacted third molars. The role of the experience of the surgeon. J Oral Maxillofac Surg 44:855–859PubMedCrossRef
30.
go back to reference Sedaghatfar M, August MA, Dodson TB (2005) Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. J Oral Maxillofac Surg 63:3–7PubMedCrossRef Sedaghatfar M, August MA, Dodson TB (2005) Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. J Oral Maxillofac Surg 63:3–7PubMedCrossRef
31.
go back to reference Tantanapornkul W, Okuchi K, Fujiwara Y, Yamashiro M, Maruoka Y, Ohbayashi N et al (2007) 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. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:253–259PubMedCrossRef Tantanapornkul W, Okuchi K, Fujiwara Y, Yamashiro M, Maruoka Y, Ohbayashi N et al (2007) 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. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:253–259PubMedCrossRef
32.
go back to reference van Gool AV, Ten Bosch JJ, Boering G (1977) Clinical consequences of complaints and complications after removal of the mandibular third molar. Int J Oral Surg 6:29PubMedCrossRef van Gool AV, Ten Bosch JJ, Boering G (1977) Clinical consequences of complaints and complications after removal of the mandibular third molar. Int J Oral Surg 6:29PubMedCrossRef
33.
go back to reference Wofford DT, Miller RI (1987) Prospective study of dysesthesia following odontectomy of impacted mandibular third molars. J Oral Maxillofac Surg 45:15–19PubMedCrossRef Wofford DT, Miller RI (1987) Prospective study of dysesthesia following odontectomy of impacted mandibular third molars. J Oral Maxillofac Surg 45:15–19PubMedCrossRef
34.
go back to reference Watanabe H, Momin MA, Kurabayashi T, Aoki H (2010) Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat 32:343–349PubMedCrossRef Watanabe H, Momin MA, Kurabayashi T, Aoki H (2010) Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat 32:343–349PubMedCrossRef
35.
go back to reference Szalma J, Edina L, Sára J, Olasz L (2011) Darkening of third molar roots: panoramic radiographic associations with inferior alveolar nerve exposure. J Oral Maxillofac Surg 69:1544–1549PubMedCrossRef Szalma J, Edina L, Sára J, Olasz L (2011) Darkening of third molar roots: panoramic radiographic associations with inferior alveolar nerve exposure. J Oral Maxillofac Surg 69:1544–1549PubMedCrossRef
36.
go back to reference Palma-CarriÓ C, Garciá-Mira B, Larrazabal-MorÓn C, Peñarrocha-Diago M (2010) Radiographic signs associated with inferior alveolar nerve damage following third molar extraction. Med Oral Patol Oral Cir Bucal 15(6):e886–e890PubMedCrossRef Palma-CarriÓ C, Garciá-Mira B, Larrazabal-MorÓn C, Peñarrocha-Diago M (2010) Radiographic signs associated with inferior alveolar nerve damage following third molar extraction. Med Oral Patol Oral Cir Bucal 15(6):e886–e890PubMedCrossRef
Metadata
Title
Correlation of mandibular impacted tooth and bone morphology determined by cone beam computed topography on a premise of third molar operation
Authors
M. A. Momin
K. Matsumoto
K. Ejima
R. Asaumi
T. Kawai
Y. Arai
K. Honda
T. Yosue
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Surgical and Radiologic Anatomy / Issue 4/2013
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-012-1031-y

Other articles of this Issue 4/2013

Surgical and Radiologic Anatomy 4/2013 Go to the issue