Dentoalveolar surgery
Measurement of the Lingual Position of the Lower Third Molar Roots Using Cone-Beam Computed Tomography

https://doi.org/10.1016/j.joms.2014.06.460Get rights and content

Purpose

The aim of this study was to evaluate the distance between the roots of the impacted third molars and the floor of the mouth to predict the risk of lingual root displacement during surgery.

Materials and Methods

Thirty-one patients (5 men and 26 women) were evaluated for this study using cone-beam computed tomography (CBCT). The teeth were grouped according to their position on the orthopantomogram as vertical, mesioangular, horizontal, and distoangular. The distance between 2 points on the roots and lingual soft tissues was measured.

Results

The average distance between the apex of the root, which is in the most lingual position, and the lingual cortical plate was 1.03 mm. The average distance between the most lingual point on the apical half of the root, which is in closer proximity, and the lingual cortical plate was 0.65 mm.

Conclusion

The distance between the apices and the lingual plate is very short, which allows displacement of broken roots or teeth, especially when the lingual plate is perforated.

Section snippets

Materials and Methods

This study was approved by the ethical committee of Istanbul University (Istanbul, Turkey; project number 723). CBCT images of 32 impacted lower third molar teeth of 31 patients (5 men and 26 women) were evaluated for this study. The data were collected from images of patients who had undergone CBCT imaging for various reasons, such as impacted teeth, dental implants, and cysts of the jaws. Ectopic teeth and teeth with cystic lesions were excluded from the study.

The CBCT mandibular scans were

Results

The measurements showed an average distance of 1.03 mm between the apices of the lower third molars and the lingual soft tissues. The average distance between the most lingually positioned point on the apical half of the root and the lingual soft tissues was 0.65 mm. The relation between the roots and the lingual soft tissues were grouped into 3 types: relation type A, in which there was an amount of bone between the root and the soft tissues (Fig 2A); relation type B, in which there was 0 mm

Discussion

Accidental displacement of lower third molars or root fragments into facial spaces is rare, and only limited information about its incidence and management is found in the literature. However, when it occurs, the most affected sites are the floor of the mouth and the submandibular and pterygomandibular spaces.26 Lingually located teeth, a thin lingual cortical plate or a fenestration in the lingual plate with tooth exposure, and application of excessive force during extraction have been

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