Cardoso Rafael Rezende, Vieira Camila Silvério Carvalho, Pereira Davisson Alves, de Oliveira Guilherme José Pimentel Lopes, de Rezende Barbosa Gabriella Lopes
School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Oral Maxillofac Surg. 2025 Apr 21;29(1):88. doi: 10.1007/s10006-025-01386-8.
To determine which factors influence lingual plate injury during the extraction of mandibular third molars, using cone beam computed tomography (CBCT) analysis, considering tooth position and lingual plate morphology.
This retrospective study included CBCT images of 35 mandibular third molars taken preoperatively and seven days post-extraction. The images were obtained from a previous prospective clinical trial investigating bone healing. In the preoperative images, six parameters were evaluated: lingual plate thickness, impaction depth, mesiodistal and buccolingual angulation, lingual plate morphology, and the topographic relationship between the root apex and the lingual plate. In the postoperative images, the lingual plate was classified as either intact or fractured. Statistical analysis was performed using logistic regression to assess the influence of the different variables on lingual plate damage.
CBCT images of 35 mandibular third molars were analyzed. Logistic regression analysis revealed that lingual plate thickness at the level of the cementoenamel junction significantly influenced the likelihood of plate fracture during extraction (95% CI: -1.19 to -0.20; p =.007).
Understanding lingual plate thickness variations can aid in surgical planning and reduce intraoperative complications in lower third molars extraction. CBCT may be particularly useful in cases involving complex impactions.
The clinical trial from which the CBCT images were obtained was registered in the Brazilian Registry of Clinical Trials (REBEC) under number U1111-1263-9675.
利用锥形束计算机断层扫描（CBCT）分析，考虑牙齿位置和舌侧板形态，确定在下颌第三磨牙拔除过程中哪些因素会影响舌侧板损伤。
这项回顾性研究纳入了35颗下颌第三磨牙术前及拔牙后7天的CBCT图像。这些图像来自之前一项调查骨愈合情况的前瞻性临床试验。在术前图像中，评估了六个参数：舌侧板厚度、阻生深度、近远中向和颊舌向角度、舌侧板形态以及根尖与舌侧板的地形关系。在术后图像中，舌侧板被分类为完整或骨折。使用逻辑回归进行统计分析，以评估不同变量对舌侧板损伤的影响。
分析了35颗下颌第三磨牙的CBCT图像。逻辑回归分析显示，釉牙骨质界水平的舌侧板厚度对拔牙过程中板骨折的可能性有显著影响（95%可信区间：-1.19至-0.20；p = 0.007）。
了解舌侧板厚度变化有助于手术规划，并减少下颌第三磨牙拔除术中的并发症。CBCT在涉及复杂阻生的病例中可能特别有用。
获取CBCT图像的临床试验已在巴西临床试验注册中心（REBEC）注册，编号为U1111-1263-9675。
