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Authors
Abstract(s)
A relação intrínseca do canal mandibular com a posição radicular do terceiro molar mandibular representa uma limitação anatómica importante em cirurgia de exodontia de terceiros molares mandibulares.
Com este estudo retrospetivo e observacional, pretendeu-se definir o padrão radiográfico tridimensional da relação do canal mandibular com a posição radicular do terceiro molar mandibular através da análise de Tomografias Computorizadas de Feixe Cónico.
No estudo foram analisados 45 terceiros molares mandibulares de 28 indivíduos, e as variáveis analisadas nas tomografias foram as seguintes: número de raízes, curvatura e a existência de fusão radicular, a relação com o canal mandibular no sentido crânio-caudal, vestíbulo-lingual e a existência de contacto direto entre o dente e o canal mandibular. Calculou-se o diâmetro deste e a sua localização em relação às raízes do terceiro molar.
Os resultados revelaram que a distância do canal mandibular à cortical inferior foi em média de 10,39 ± 2,89 mm; a distância do canal mandibular à cortical lingual resultou num valor médio de 2,25 ± 1,09 mm; a distância do canal mandibular à cortical vestibular apresentou um valor médio de 3,64 ± 1,35mm e a distância do canal mandibular às raízes obteve um valor médio de 1,85 ± 1,47 mm. O diâmetro médio do canal mandibular obtido neste estudo foi de 3,23 ± 0,53 mm. Quanto à localização do canal em relação às raízes, observaram-se vinte e quatro casos (53,3%) com localização vestibular, treze (28,9%) com localização lingual e oito (17,8%) com localização inferior à raiz.
Em suma, o canal mandibular apresenta maioritariamente uma posição vestibular em relação às raízes do terceiro molar mandibular e assume uma posição lingual em relação às corticais ósseas mandibulares. A proximidade do ápice radicular ao canal assume importância no planeamento de cirurgias de exodontia de terceiros molares.
The intimate relation between the mandibular canal and the root position of the mandibular third molar presents as a surgical challenge in terms of anatomical relation. This retrospective and observational study aims to define the three-dimensional radiographic pattern of the mandibular canal relation to the root position of the mandibular third molar through a Cone-Beam Computed Tomography analysis. This study assessed 45 mandibular thirds molars of 28 individuals and the following variables: number of roots, curvature and the existence of root fusion, the relationship with the mandibular canal in the cranio-caudal and bucco-lingual direction, as well as the existence of direct contact between the tooth and the mandibular canal. The diameter of the canal and location in relation to the roots of the third molar were also determined. The results showed that the mean distance of the mandibular canal to the lower cortical was 10,39 ± 2,89 mm; the distance from the mandibular canal to the lingual cortical resulted in a mean value of 2,25 ± 1,09 mm; the distance from the mandibular canal to the buccal cortical had a mean value of 3,64 ± 1,35 and the distance from the mandibular canal to the roots obtained a mean value of 1,85 ± 1,47 mm. The average diameter of the mandibular canal obtained was 3,23 ± 0,53 mm. As for the location of the canal in relation to the roots, twenty-four cases (53,3%) with a buccal location, thirteen cases (28,9%) with lingual location and eight cases (17,8%) with a lower location to the root were observed. In short, the mandibular canal is mainly in a buccal position in relation to the roots of mandibular third molar and assumes a lingual position on the mandibular bone. The proximity of the root apex to the canal assumes importance in planning the third molar extraction.
The intimate relation between the mandibular canal and the root position of the mandibular third molar presents as a surgical challenge in terms of anatomical relation. This retrospective and observational study aims to define the three-dimensional radiographic pattern of the mandibular canal relation to the root position of the mandibular third molar through a Cone-Beam Computed Tomography analysis. This study assessed 45 mandibular thirds molars of 28 individuals and the following variables: number of roots, curvature and the existence of root fusion, the relationship with the mandibular canal in the cranio-caudal and bucco-lingual direction, as well as the existence of direct contact between the tooth and the mandibular canal. The diameter of the canal and location in relation to the roots of the third molar were also determined. The results showed that the mean distance of the mandibular canal to the lower cortical was 10,39 ± 2,89 mm; the distance from the mandibular canal to the lingual cortical resulted in a mean value of 2,25 ± 1,09 mm; the distance from the mandibular canal to the buccal cortical had a mean value of 3,64 ± 1,35 and the distance from the mandibular canal to the roots obtained a mean value of 1,85 ± 1,47 mm. The average diameter of the mandibular canal obtained was 3,23 ± 0,53 mm. As for the location of the canal in relation to the roots, twenty-four cases (53,3%) with a buccal location, thirteen cases (28,9%) with lingual location and eight cases (17,8%) with a lower location to the root were observed. In short, the mandibular canal is mainly in a buccal position in relation to the roots of mandibular third molar and assumes a lingual position on the mandibular bone. The proximity of the root apex to the canal assumes importance in planning the third molar extraction.
Description
Keywords
Terceiro molar Mandíbula Imagens tridimensionais Tomografia Computorizada de Feixe Cónico Nervo alveolar inferior Third molar Cone-Beam Computed Tomography Inferior alveolar nerve Mandible Three-dimensional Imaging