Topic Highlight
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World J Radiol. Jul 28, 2014; 6(7): 417-423
Published online Jul 28, 2014. doi: 10.4329/wjr.v6.i7.417
Clinical significance of computed tomography assessment for third molar surgery
Kenji Nakamori, Kei Tomihara, Makoto Noguchi
Kenji Nakamori, Kei Tomihara, Makoto Noguchi, Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama 930-0194, Japan
Author contributions: Nakamori K reviewed the relevant literature and wrote the manuscript; Tomihara K and Noguchi M organized the research and edited and revised the manuscript.
Correspondence to: Kenji Nakamori, DDS, PhD, Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan. nakamori@med.u-toyama.ac.jp
Telephone: +81-76-434-5041 Fax: +81-76-434-5041
Received: December 24, 2013
Revised: March 27, 2014
Accepted: May 28, 2014
Published online: July 28, 2014
Abstract

Surgical extraction of the third molar is the most commonly performed surgical procedure in the clinical practice of oral surgery. Third molar surgery is warranted when there is inadequate space for eruption, malpositioning, or risk for cyst or odontogenic tumor formation. Preoperative assessment should include a detailed morphologic analysis of the third molar and its relationship to adjacent structures and surrounding tissues. Due to developments in medical engineering technology, computed tomography (CT) now plays a critical role in providing the clear images required for adequate assessment prior to third molar surgery. Removal of the maxillary third molar is associated with a risk for maxillary sinus perforation, whereas removal of the mandibular third molar can put patients at risk for a neurosensory deficit from damage to the lingual nerve or inferior alveolar nerve. Multiple factors, including demographic, anatomic, and treatment-related factors, influence the incidence of nerve injury during or following removal of the third molar. CT assessment of the third molar prior to surgery can identify some of these risk factors, such as the absence of cortication between the mandibular third molar and the inferior alveolar canal, prior to surgery to reduce the risk for nerve damage. This topic highlight presents an overview of the clinical significance of CT assessment in third molar surgery.

Keywords: Computed tomography, Third molar, Extraction, Oral surgery, Assessment

Core tip: Surgical extraction of the third molar is the most commonly performed procedure in oral surgery. Careful preoperative examinations, including the use of computed tomography (CT) assessment, assist in the planning of in predicting the risks related to surgical interventions. The clinical significance of CT assessment in relation to third molar surgery is therefore reviewed and discussed.