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Evaluation of diagnostic accuracy of panoramic radiography according to cone beam computed tomography in the detection of relationship between mandibular third molar teeth and inferior alveolar nerve
Nima Biuki, Mohammad Aghaali, Allahyar Jahangir, Ali Saleh, Mahboubeh Pourabdollahi, Aida Mehdipour,
Volume 38, Issue 0 (4-2025)
Abstract
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.

Evaluation of the prevalence of root resorption in teeth adjacent to impacted maxillary canines using cone-beam computed tomography
Aydin Alipour, Ehsan Moudi, Seyedali Seyedmajidi, Meisam Moradi, Reza Faraji,
Volume 39, Issue 0 (3-2026)
Abstract
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Background and Aims: Root resorption of teeth adjacent to impacted canines, although relatively uncommon, is a potentially harmful condition that may lead to tooth loss. Early diagnosis and the use of accurate imaging techniques play a crucial role in preventing from root resorption complications. This study aimed to evaluate the prevalence of root resorption in teeth adjacent to impacted maxillary canines using cone-beam computed tomography (CBCT) images.

Materials and Methods: In this retrospective observational-analytical study, 60 CBCT images of patients with impacted maxillary canines (15 bilateral case and 45 unilateral cases) were examined using a convenience sampling method among those referred to oral and maxillofacial radiology clinics in northern Iran, Babol, in 2023. Variables such as age, gender, position and direction of canine eruption, presence of root resorption in adjacent teeth, type of affected tooth, severity, and location of resorption were evaluated. Data were analyzed using the chi-square test in SPSS software at a significance level of 0.05.

Results: Among the studied CBCT (66.7% female; 70% over 18 years of age), 75 cases of impaction (41 cases on the right and 34 cases on the left) were observed. Root resorption in the teeth adjacent to the impacted maxillary canines was observed in only 7 patients (11.7%). All resorptions were mild and observed in the lateral incisors. In terms of vertical position, 85.7% of the cases occurred in the middle third of the root. There was no statistically significant association between root resorption and gender, age, or the position or direction of canine eruption (P>0.05).

Conclusion: Given the potential for root resorption in lateral incisors and in the middle third of the root, it is recommended that oral and maxillofacial surgeons and orthodontists perform a thorough initial evaluation of the canine’s position and adjacent teeth using CBCT imaging prior to treatment to prevent possible complications.


Investigation of the prevalence of missed MB2 canals in root canal-treated maxillary first molars using CBCT in patients referred to Borujerd dental school (2014-2018) 
Marjan Babadi Borujeni, Parisa Ilkhanizadeh, Hiva Ebrahimi,
Volume 39, Issue 0 (3-2026)
Abstract
Background and Aims: Identification of the second mesiobuccal canal (MB2) in maxillary first molars is considered one of the major challenges in endodontic treatment. This study aimed to investigate the prevalence of missed MB2 canals using cone-beam computed tomography (CBCT).
Materials and Methods: This descriptive-analytical retrospective study was conducted on CBCT images taken in years between 2014 and 2018. The images were selected from patients who had undergone treatment on the maxillary first molars and had visited the radiology department of Borujerd dental school. Inclusion criteria were adequate image quality and presence of root canal treatment, while exclusion criteria included incomplete images and teeth lacking complete treatment. Image analysis was performed by an oral radiology specialist. Sample size was calculated using a statistical formula considering confidence level and study power. Data analysis was performed using descriptive statistics and Spearman’s correlation test in SPSS (version 18) at a significance level of P<0.05.
Results: Out of 90 patients examined, 59 cases (65.5%) had an MB2 canal, of which 56 cases (62.2%) had not been identified during initial treatment. The prevalence of MB2 canals was significantly higher in males than in females (P<0.01). No statistically significant association was found between the presence of periapical radiolucency and MB2 canals. In most cases, the MB2 canal orifice appeared as a separate opening.
Conclusion: The results of this study indicated a high prevalence of missed MB2 canals during initial endodontic treatment. The use of CBCT can play an effective role in detecting these canals and improving the success rate of endodontic therapy. Considering individual characteristics such as gender may aid in more accurate diagnosis.
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