Comparisons of the Computed Tomographic Scan and Panoramic Radiography Before Mandibular Third Molar Extraction Surgery

BACKGROUND: Mandibular third molar extraction surgery has a postoperative complication of hypoesthesia of the lower lip and/or chin. The objective of the study was to determine if preoperative radiographic examination by panoramic radiography and computed tomography (CT) scan can predict postoperative complications of mandibular third molar extraction surgery. MATERIAL/METHODS: In total, 479 patients who had mandibular third molar extraction surgery were included in this cross-sectional study. Patients had panoramic radiographies and CT scans to determine the relationship of the tooth, the canal, and the buccolingual position. Inferior alveolar nerve sensory impairment was detected using a two-point discrimination method. Wilcoxon test and Tukey’s test were used to compare diagnostic modalities at a 99% confidence level. RESULTS: Inferior alveolar nerve was more successfully quantified by CT scan compared to panoramic radiography (p<0.0001, q=8.062). Orthopantomography was better than the CT scan in detecting a close relationship of the tooth and the canal (p<0.0001, q=25.609), but the CT scan was better in detecting the buccolingual position of the teeth (p<0.0001, q=36.757). The age of patients (p<0.0001, q=36.757), postoperative bleeding (p<0.0001, q=15.981), and experience of the surgeon (p<0.0001, q=10.99) had an affected on inferior alveolar nerve sensory impairment. CONCLUSIONS: Preoperative panoramic radiography, CT scan, age, the experience of the surgeon, and postoperative bleeding can predict postoperative complications for extraction of a mandibular third molar.