Topographic Association of the Inferior Dental Canal with Different Patterns of Impacted Third Molar Using Cone Beam Computed Tomography: A Cross-Sectional Study
Keywords:
Inferior dental canalAbstract
OBJECTIVE: To determine the Cone Beam Computed Tomography (CBCT) based evaluation of the intimate relationship between impacted third molar teeth and the Inferior Dental Canal (IDC) before its surgical removal.
METHODOLOGY: This retrospective cross-sectional study was conducted on patients visiting the radiography department at Khyber College of Dentistry between January 2022 and January 2023. The sample size calculated was 200 patients. The age range was 25-45 years. CBCT images were obtained using the Planmeca dental system at 90 kVp. The 3-D generated view was used to determine the Maglione (CBCT-based Inferior Dental Canal (IDC) intimacy 3rd molar), Winter's, and Gregory's classifications for the angulation, location, and space of impacted teeth. The data were analyzed using SPSS 16, with a level of significance of of P? 0.05.
RESULTS: The average age group was 29.6±5 years. The male-to-female ratio was 3:2. Winter classified most impacted teeth as vertically affected. Pell/Gregory classified most of the impaction at position B and Class II for both genders. The P-value was similarly highly significant (p = 0.001) for IDC morphometric measures recorded in both genders. According to the Maglione classification, the fourth pattern (4a, 22%) was the most prevalent on CBCT. The most common radiographic symptom of IDC associated with an impacted third molar tooth was a combination of deflected root and deviated canal.
CONCLUSION: The Maglione Class 4(a) was the most common presentation of impacted third molar with preserved diameter of IDC among both genders.
References
1. Balaji K, Bhardwaj A. A review on extraction of impacted third molars: Indications and complications. J Dent Res Pract. 2020; 6(2): 35-41.
2. Nazir MA. Prevalence and indications for surgical extraction of lower third molars: A retrospective study in a dental hospital in Saudi Arabia. BMC Oral Health. 2020; 20: 1-7.
3. Weiss, R.; Read-Fuller, A.M. Cone Beam Computed Tomography in oral and maxillofacial surgery: An evidence-based review. Dent J. 2019; 7: 52. doi: 10.3390/dj7020052.
4. Jacobs R, Salmon B, Codari M, Hassan B, Bornstein MM. Cone beam computed tomography in implant dentistry: Recommendations for clinical use. BMC Oral Health. 2018; 18: 88-100. doi: 10.1186/s12903-018-0523-5.
5. Aljarbou FA, Aldosimani MA, Althumairy RI, Alhezam AA, Aldawsari AI. An analysis of the first and second mandibular molar roots' proximity to the inferior alveolar canal and cortical plates using cone beam computed tomography among the Saudi Population. Saudi Med J. 2019;40(2):189-194. doi: 10.15537/smj.2019.2.23602.
6. Synan W, Stein K. Management of impacted third molars. Oral Maxillofac Surg Clin North Am. 2020; 32(4): 519-59. doi: 10.1016/j.coms.2020.07.002
7. Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003; 61: 1379-89.doi: 10.1016/j.joms.2003.04.001.
8. Maglione M, Costantinides F, Bazzocchi G. Classification of impacted mandibular third molars on cone-beam CT images. J Clin Exp Dent. 2015; 7(2): 224-31. doi: 10.4317/jced.51984.
9. Kautto A, Vehkalahti MM, Ventä I. Age of the patient at the extraction of the third molar. Int J Oral Maxfax Surg. 2018; 47(7): 947-51. doi: 10.1016/j.ijom.2018.03.020
10. Jaro? A, Trybek G. The pattern of mandibular third molar impaction and assessment of surgery difficulty: A retrospective study of radiographs in East Baltic Population. Int J Environ Res Public Health. 2021; 18(11): 23-31. doi: 10.3390/ijerph18116016
11. Srivastava S, Alharbi HM, Alharbi AS, Soliman M, Eldwakhly E, Abdelhafeez MM. Assessment of the proximity of the inferior alveolar canal with the mandibular root apices and cortical plates—A retrospective cone beam computed tomographic analysis. J Pers Med. 2022;12(11):1784. doi: 10.3390/jpm12111784.
12. Nazir M. Postoperative Complications of Third Molar Surgery: A Systematic Review. Int J Oral Maxillofac Surg. 2020; 49(2): 156-172.
13. Choo S, Wey MC, Ngeow WC, Chai WL, Alam MK. The spatial relationship and distances of posterior root apices to various anatomical structures. Int Med J. 2018 Feb 1;25(1):45-50.
14. Cameron CE, Widmer C. Indications for Extraction of Third Molars: A Review of the Literature. Int J Oral Maxillofac Surg. 2020; 49(2): 139-145.
15. Buser D, Règine M. Complications Following Third Molar Surgery: An Overview. Eur J Oral Implantol. 2021; 13(1): 27-35.
16. Harrison JE. Edwards WD. Complications of Third Molars: Prevalence and Risk Factors. J Oral Facial Surg. 2020; 78(5): 735-742.
17. Jiang H. Risk Factors for Complications after Third Molar Extraction: A Meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020; 129(1): 48-56.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Journal of Liaquat University of Medical & Health Sciences

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Submission of a manuscript to the journal implies that all authors have read and agreed to the content of the undertaking form or the Terms and Conditions.
When an article is accepted for publication, the author(s) retain the copyright and are required to grant the publisher the right of first publication and other non-exclusive publishing rights to JLUMHS.
Articles published in the Journal of Liaquat University of Medical & health sciences are open access articles under a Creative Commons Attribution-Noncommercial - Share Alike 4.0 License. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. This is in accordance with the BOAI definition of open access. In addition to that users are allowed to remix, tweak and build upon the work non-commercially as long as appropriate credit is given and the new creations are licensed under the identical terms. Or, in certain cases it can be stated that all articles and content there in are published under creative commons license unless stated otherwise.

















