Yeditepe J Dent. 2018; 14(3): 99-103 | DOI: 10.5505/yeditepe.2018.40326

Mandibular gömülü üçüncü molar diþler ile mandibular kanal arasýndaki iliþkinin dental volümetrik tomografi ile deðerlendirilmesi

Mohammed Ghazý Allan Salahaldýn, Berkem Atalay
Ýstanbul Üniversitesi Diþ Hekimliði Fakültesi, Çene Cerrahisi Anabilim Dalý, Ýstanbul

GÝRÝÞ ve AMAÇ: Oral cerrahide inferior alveolar sinirin korunmasý çok önemlidir; Bu nedenle, anatomik pozisyonu, cerrahi müdahalelerden önce kesin olarak tanýmlanmalýdýr. Konik ýþýnlý bilgisayarlý tomografi (KIBT), sýnýrlý bölgelerde doðru yüksek çözünürlüklü görüntüler saðlayabilir, böylece inferior alveolar kanalýn (ÝAK) yolunu ve diðer anatomik yapýlarla iliþkisini bulmak için kullanýlabilir.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya Ýstanbul Üniversitesi Diþ Hekimliði Fakültesi Oral ve Maksillofasiyal Cerrahi Anabilim Dalý'na Kasým 2015-Mart 2016 tarihleri arasýnda baþvuran 100 hasta dahil edildi. Her bir katýlýmcýdan mandibular üçüncü molar diþlerin deðerlendirilmesi için panoramik radyografi ve KIBT alýndý. Olgular mandibuler üçüncü molar diþleri ile panoramik radyografi ve KIBT'deki ÝAK arasýndaki anatomik iliþkiye göre sýnýflandýrýldý. Veriler, Tukey testi kullanýlarak karþýlaþtýrýldý.
BULGULAR: Mandibular üçüncü molar diþ ve ÝAK incelendiðinde, ÝAK'nýn 62 olguda 1 mm'den daha yakýn olduðu ve 28 olguda mesafenin 1-2 mm arasýnda olduðu saptanmýþtýr. Mesafenin 2 mm'den fazla olduðu 10 olguda ÝAK ve diþler birbirine karýþmamýþtýr. Bulgularýmýz ÝAK'nýn retromolar bölgeden molar bölgeye indiðini ve premolar bölgeye çýktýðýný gösterdi. Bukkal kemik molar bölgede daha kalýn iken, lingual kemik, premolar bölgede daha kalýndýr.
TARTIÞMA ve SONUÇ: KIBT, inferior alveolar sinir hasarýný önlemek için oral ve maksillofasiyal cerrahi iþlemlerden önce yararlýdýr.

Anahtar Kelimeler: Panoramik radyografi, konik ýþýnlý bilgisayarlý tomografi, gömülü mandibular üçüncü molar, oral cerrahi komplikasyonlarý, inferior alveoler sinir, diþ çekimi.

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Evaluation of the relationship between an impacted mandibular third molar and the inferior alveolar canal using cone-beam computed tomography

Mohammed Ghazý Allan Salahaldýn, Berkem Atalay
Ýstanbul University Faculty of Dentistry, Department of Oral Surgery, Ýstanbul

INTRODUCTION: Protection and preservation of the inferior alveolar nerve are very important during oral surgery; therefore, the anatomical course should be identified precisely before surgical interventions. Cone-beam computed tomography (CBCT) can provide accurate, high-resolution images in limited regions thus can be used to locate the pathway of the inferior alveolar canal (IAC) and its relation to the other anatomical structures.
METHODS: This retrospective study included 100 patients who referred to Ýstanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery between November 2015-March 2016. Panoramic radiograph and CBCT were taken for each participant to evaluate impacted mandibular third molar (IMTM). The cases were classified, according to the anatomical relationship between the mandibular third molars and the IAC on panoramic radiograph and CBCT. Data were compared using the Tukey test.
RESULTS: When the IMTM and IAC were examined, it was determined that ýn 62 cases IAC was closer than 1 mm and in 28 cases the distance was between 1-2 mm. IAC and teeth did not associate in 10 cases where the distance was more than 2 mm. Our findings showed that the IAC descended from the retromolar region to the molar region and ascended to the premolar region. The buccal bone is thicker in the molar region, whereas the lingual bone is thicker in the premolar region.
DISCUSSION AND CONCLUSION: CBCT is useful before oral and maxillofacial surgery procedures to avoid inferior alveolar nerve injury.

Keywords: Panoramic radiography, Cone-beam computed tomography, Impacted mandibular third molar, Oral surgical complications, Inferior alveolar nerve, Tooth Extraction.

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