Journal of Dental Medicine

Background and Aims: In impacted third molar surgery, panoramic radiography is a preliminary technique for assessing the consequences associated with inferior alveolar nerve injury. However, this technique cannot provide enough information to determine the true risk in all cases. The aim of this study was to compare the accuracy of panoramic and CBCT radiographs in evaluating the relationship between the mandibular impacted third molars and the inferior alveolar nerve.
Materials and Methods: In this cross-sectional study, the relationship between mandibular third molar and inferior alveolar nerve in 15 patients referred to the oral and maxillofacial radiology department of Birjand dental school including 20 mandibular third molars were evaluated using two panoramic and CBCT radiographs. Data were analyzed using descriptive statistics and chi-square test and sensitivity analysis in SPSS22.
Results: In the evaluation of the teeth using panoramic radiography, the highest frequency was related to root darkening (65%) and root deflection (65%), and the lowest frequency was related to root narrowing (20%) and canal deviation (5%). The highest sensitivity of panoramic criteria was related to the root darkening with 100% sensitivity and the lowest sensitivity was related to the canal deviation with 17% sensitivity. On the other hand, the highest specificity of panoramic criteria between the mandibular third molars with the inferior alveolar nervewas was related to the two criteria of bifid apex and canal deviation with 100% specificity. The lowest specificity was related to the root deflection with 21% of specificity.
Conclusion: According to the results of this study, the probability of observing relationship between the mandibular third molars with the inferior alveolar nerve in CBCT radiography was very high.

Background and Aims: Knowing the depth and type of the teeth impaction with radiographic approaches can guide the clinicians into selecting the most appropriate treatment and prevent surgical complications. Therefore, the purpose of this article was to evaluate the prevalence of canine and premolar impaction in the digital panoramic view of patients referred to Rasht dental school in 2019.
Materials and Methods: This annalistic-descriptive cross-sectional study comprised patients who attended the Faculty of Dentistry, Rasht, Iran in 2019. Dental records and panoramic radiographs of 500 patients were reviewed retrospectively. Demographic information as well as the type and depth of impaction, involved jaw, and also, the associated pathological lesions were recorded. Data were analyzed with SPSS24 version with significant level of P<0.05.
Results: The findings revealed that among 500 individuals (300 (60%) were females and 200 (40%) were males), 35 individuals (7%) had at least one impacted tooth, 80% of impacted teeth were canines and the others were premolars. The most common impaction type, impaction level, and pathological lesion were mesioangular, B, and carries of the adjacent tooth, respectively. A significant relation was not observed between the type and level of impaction with the involved jaw (P=0.15, P=0.99) and also, the relation between the type of pathological lesion and gender was insignificant (P=0.85).
Conclusion: Functional and esthetic complications of impacted tooth can be prevented or declined by on-time radiographic screening.

Background and Aims: Idiopathic osteosclerosis is an asymptomatic local growth of cortical bone and is discovered incidentally on panoramic radiographs. The purpose of this study is to evaluate the frequency of idiopathic osteosclerosis and its radiographic features in panoramic images of patients referred to the Department of Maxillofacial Radiology, Faculty of Dentistry, Arak University of Medical Sciences (Iran) in 2022-2023.
Materials and Methods: In this cross-sectional study, 460 panoramic images from the radiology department of Arak Faculty of Dentistry were randomly selected and analyzed. The demographic information of patients, frequency of idiopathic osteosclerosis, location, and also its relationship with adjacent teeth in terms of proximity to lamina dura and periodontal ligament and radiographic features in terms of size and morphology were evaluated. The data were analyzed using the SPSS24 software.
Results: Panoramic images of 460 patients (266 men and 194 women) with an average age of 38.12 (11.75) years were evaluated. The frequency of idiopathic osteosclerosis was 6.1% (28 images). 92.9% of the lesions were in the lower jaw and 46.4% of them were near the premolar teeth. In 39.3% of the cases, the lesion was adjacent to the periodontal ligament and laminadora of the tooth. In 3.6% of the cases, it was associated with a small displacement of the adjacent tooth, and 17.9% was associated with tooth root resorption. According to the results, there was no correlation between the incidence of this lesion with age and gender (P>0.05).
Conclusion: According to the findings of this study, the frequency of idiopathic osteosclerosis in the patients referred to Arak dental school was reported as 6.1%. Most of these lesions were observed in the back of the lower jaw and thus, it is important to be able to distinguish this lesion from the radiopaque lesions of the jaw which need treatment.

Background and Aims: Third molar teeth extraction is one of the common treatments procedure in dentistry. The proximity of mandibular third molar teeth to the inferior alveolar nerve canal may make the surgery challenging and cause adverse complications. The purpose of this study was to determine the accuracy of diagnostic and evaluation of panoramic radiography findings in two classification methods (Rood-Shehab and Tanaka) according to CBCT in mandibular third molar extraction surgery.
Materials and Methods: This cross-sectional analytical study was conducted on 65 patients of a private radiology clinic in Qom who had simultaneous panoramic and CBCT radiography. Panoramic and CBCT radiographs were imported into Scanora and Ondemand softwares, respectively. The relation of the mandibular third molar with the inferior alveolar nerve was evaluated according to Tanaka's classification and Rood-Shehab radiographic signs and compared with CBCT radiographs. Finally, the obtained data were analyzed by chi-square test, ROC curve and SPSS software version 24. The significant level was considered at P<0.05.
Results: Out of 65 samples, 23.1% were men and 76.9% were women. The mean age of participants was 26.9±8.77. There was a significant relation between the Tanaka's classification of panoramic radiographs and proximity to the nerve in CBCT radiographs (P=0.011). This relationship was significant when the number of radiographic signs of the Rood-Shehab classification increased (P=0.044). Root darkening and diversion of mandibular nerve canal signs of Rood-Shehab classification showed more diagnostic accuracy in the nerve canal contact determination than that of other signs.
Conclusion: The probability of contact of third molar root with the inferior alveolar nerve canal increases with increasing in the number of Rood-Shehab radiographic signs. The root darkening sign was more accurate and followed by mandibular canal diversion sign. Tanaka’s classification can be used in differentiating cases without contact to the nerve canal.