Leung Yiu Yan, Hung Kuo Feng, Li Dion Tik Shun, Yeung Andy Wai Kan
Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Oral and Maxillofacial Radiology, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
Diagnostics (Basel). 2023 Mar 1;13(5):919. doi: 10.3390/diagnostics13050919.
Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs like orthopantomogram have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbours the inferior alveolar nerve, can be clearly identified on CBCT. It also allows the assessment of potential root resorption of the adjacent second molar as well as the bone loss at its distal aspect as a consequence of the third molar. This review summarized the application of CBCT in the risk assessment of lower third molar surgery and discussed how it could aid in the decision-making of high-risk cases to improve safety and treatment outcomes.
下颌第三磨牙手术存在风险,如下牙槽神经损伤可能会导致永久性后果。手术前进行风险评估很重要,这是知情同意过程的一部分。传统上,全景片等普通X光片一直被常规用于此目的。锥形束计算机断层扫描(CBCT)在评估下颌第三磨牙手术时,能从三维图像中提供更多信息。在下颌第三磨牙手术评估中,CBCT可以清晰显示牙根与容纳下牙槽神经的下牙槽神经管的接近程度。它还可以评估相邻第二磨牙潜在的牙根吸收情况,以及由于第三磨牙导致的其远中面的骨质流失。本综述总结了CBCT在下颌第三磨牙手术风险评估中的应用,并讨论了它如何有助于高危病例的决策,以提高安全性和治疗效果。