Document Detail


Cortical integrity of the inferior alveolar canal as a predictor of paresthesia after third-molar extraction.
MedLine Citation:
PMID:  20194382     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paresthesia is a well-known complication of extraction of mandibular third molars (MTMs). The authors evaluated the relationship between paresthesia after MTM extraction and the cortical integrity of the inferior alveolar canal (IAC) by using computed tomography (CT). METHODS: The authors designed a retrospective cohort study involving participants considered, on the basis of panoramic imaging, to be at high risk of experiencing injury of the inferior alveolar nerve who subsequently underwent CT imaging and extraction of the MTMs. The primary predictor variable was the contact relationship between the IAC and the MTM as viewed on a CT image, classified into three groups: group 1, no contact; group 2, contact between the MTM and the intact IAC cortex; group 3, contact between the MTM and the interrupted IAC cortex. The secondary predictor variable was the number of CT image slices showing the cortical interruption around the MTM. The outcome variable was the presence or absence of postoperative paresthesia after MTM extraction. RESULTS: The study sample comprised 179 participants who underwent MTM extraction (a total of 259 MTMs). Their mean age was 23.6 years, and 85 (47.5 percent) were male. The overall prevalence of paresthesia was 4.2 percent (11 of 259 teeth). The prevalence of paresthesia in group 3 (involving an interrupted IAC cortex) was 11.8 percent (10 of 85 cases), while for group 2 (involving an intact IAC cortex) and group 1 (involving no contact) it was 1.0 percent (1 of 98 cases) and 0.0 percent (no cases), respectively. The frequency of nerve damage increased with the number of CT image slices showing loss of cortical integrity (P=.043). CONCLUSIONS: The results of this study indicate that loss of IAC cortical integrity is associated with an increased risk of experiencing paresthesia after MTM extraction.
Authors:
Wonse Park; Ji-Wook Choi; Jae-Young Kim; Bong-Chul Kim; Hyung Jun Kim; Sang-Hwy Lee
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  141     ISSN:  1943-4723     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-06-10     Revised Date:  2010-07-02    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  271-8     Citation Subset:  D; IM    
Affiliation:
Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Alveolar Process / innervation,  radiography*
Cohort Studies
Female
Humans
Male
Mandible / innervation,  radiography*
Mandibular Nerve / injuries,  radiography
Middle Aged
Molar, Third / surgery*
Paresthesia / etiology*
Postoperative Complications*
Radiography, Panoramic
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Tooth Crown / radiography
Tooth Extraction* / adverse effects
Tooth Root / radiography
Young Adult
Comments/Corrections
Comment In:
J Am Dent Assoc. 2010 Jul;141(7):828-9; author reply 829   [PMID:  20592397 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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