The Relationship of Mandibular Third Molars with Inferior Alveolar Nerve Based on Orthopantomogram

Introduction: A tooth that is unable to erupt completely due to some physiological barrier is called impaction. The extraction of the impacted mandibular 3rd molar is the most frequent procedure in oral surgery. The removal of 3rd molar is associated with complications like damage to the inferior alveolar nerve which causes paresthesia of the lower lip depending upon the severity of the damage. Objectives: This study assesses the diagnostic efficacy of orthopantomograph in predicting the association between mandibular third molar roots and inferior alveolar canal and its juxtaposition with intra-operative surgical findings. Material and methods: This cross-sectional research was conducted in the department of Oral & Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore, requiring extraction of mandibular third molars surgically. Patients underwent extraction under local anesthesia. The association between M3 and IAC by comparing OPG findings with intra-operative surgical findings was assessed by chi-square analysis. Results: One hundred and twenty patients requiring mandibular third molar extraction were included in the study. The age of the patients involved in the study ranged from 21-70 years. There were 5 cases of nerve injury in the age group of 31-40 and 1 case in each age group of 21-30 and 41-50. Conclusion: The chances of nerve damage also increase significantly when there is more than one radiographic sign present and the tooth is deeply placed in the mandible nearest to the IAN.