Shokri Abbas, Farnia Ashkan Sadeghi, Heidari Ali, Abbasiyan Forough, Alafchi Behnaz
Department of Oral and Maxillofacial Radiology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
Imaging Sci Dent. 2025 Jun;55(2):114-125. doi: 10.5624/isd.20240243. Epub 2025 Apr 28.
This study was performed to assess the relationship of the third molars with the mandibular canal as a predictor of inferior alveolar nerve (IAN) sensory disturbances using panoramic radiography (PR) and cone-beam computed tomography (CBCT).
A systematic search was conducted of 4 databases-PubMed, Scopus, Web of Science, and Google Scholar-for the period from 1985 to 2024. In the retrieved articles, the outcome of interest was the relationship of the mandibular canal with the third molars on PR and CBCT scans. The risk of bias was assessed using the Newcastle-Ottawa Scale, and quantitative meta-analysis was performed using STATA. A random-effects restricted maximum likelihood model was employed for the meta-analysis, and the I statistic was used to assess heterogeneity.
A total of 1,635 articles were initially retrieved. After a rigorous selection process, 20 studies were included in the qualitative synthesis, and 8 were selected for the meta-analysis. The findings indicated that CBCT yielded higher prevalence rates for root darkening, root deflection, interruption of the white line, diversion of the mandibular canal, and narrowing of the mandibular canal (theta values: 49.962, 4.76, 8.09, 2.229, and 4.708, respectively) compared with PR (theta values: 1.363, 1.605, 6.322, 0.655, and 1.449, respectively).
CBCT was more accurate than PR in investigating predictors of IAN paresthesia in mandibular third molar surgery. Considering the higher prevalence of paresthesia in the presence of root darkening, CBCT may be highly efficient in detecting this parameter and thus aiding in the prevention of paresthesia.
本研究旨在通过全景X线摄影（PR）和锥形束计算机断层扫描（CBCT）评估第三磨牙与下颌管的关系，以此作为下牙槽神经（IAN）感觉障碍的预测指标。
对1985年至2024年期间的4个数据库——PubMed、Scopus、科学网和谷歌学术进行系统检索。在检索到的文章中，感兴趣的结果是PR和CBCT扫描中下牙槽神经与第三磨牙的关系。使用纽卡斯尔-渥太华量表评估偏倚风险，并使用STATA进行定量荟萃分析。荟萃分析采用随机效应限制最大似然模型，I统计量用于评估异质性。
最初共检索到1635篇文章。经过严格筛选，20项研究纳入定性综合分析，8项研究被选入荟萃分析。结果表明，与PR相比，CBCT在牙根变黑、牙根弯曲、白线中断、下颌管移位和下颌管狭窄方面的发生率更高（θ值分别为49.962、4.76、8.09、2.229和4.708）（PR的θ值分别为1.363、1.605、6.322、0.655和1.449）。
在研究下颌第三磨牙手术中IAN感觉异常的预测指标方面，CBCT比PR更准确。鉴于牙根变黑时感觉异常的发生率较高，CBCT在检测该参数方面可能非常有效，从而有助于预防感觉异常。
