Comparação entre o grau de confiabilidade entre a radiografia panorâmica digital e a tomografia computadorizada de feixe cônico na análise da topografia das raízes de terceiros molares inferiores e do canal mandibular

Abstract

Introduction: The extraction of lower third molars (3MI) is one of the most commonly performed surgical procedures in the clinical routine of dental surgeons. However, there is a complication commonly associated with the removal of these teeth, namely injury to the inferior alveolar nerve (IAN), which occurs due to the proximity of the roots of these teeth to the IAN. Predicting the proximity of the IAN to the roots of the impacted lower third molar can greatly reduce the complications arising from the removal of these teeth. It is quite common during pre-surgical planning to request imaging exams such as digital panoramic radiography (DPR), which constantly shows overlaps of the roots of lower third molars on the mandibular canal, and cone beam computed tomography (CBCT) in more complex cases.  Objectives: The general objective of this study is to comparatively analyze the degree of accuracy in the topographic analysis of digital panoramic radiography and cone beam computed tomography in relation to the roots of the lower third molars and the inferior alveolar nerve. Methodology: This is a qualitative cross-sectional exploratory field study in which panoramic radiographic examinations and CBCT scans were selected from 100 patients at a private radiology clinic in the city of Imperatriz, Maranhão, Brazil. Conclusion: Thus, DPR proved to be efficient in initial surgical planning, but CBCT was necessary in more complex cases due to its three-dimensional characteristics.  Among the results obtained, the most evident radiographic sign in RPD is the interruption of the radiopaque line of the mandibular canal, followed by darkening of the roots, which are the most suggestive of intimacy with the mandibular canal.