Diagnostic Accuracy of Panoramic Radiography in Determining the Position of Impacted Third Molars in Relation to the Inferior Dental Canal Compared with Surgery

Background/Objective: Extraction of the third lower molar tooth is one of the common surgical procedures that may lead to the damage of the infra-alveolar nerve. This damage could be related to deep impacted third molar teeth and roots close to the mandibular canal. Therefore, the radiography evaluation of the position of this tooth in relation to the inferior dental canal is important before surgery. Patients and Methods: In this cross-sectional descriptive study, 59 patients who were referred to maxillofacial surgeons for third molar tooth surgery, and had a panoramic radiography were enrolled into the study. The positions of the impacted teeth in the panoramic radiography were determined according to their relation to the mandibular canal and were reported as five different subgroups (A, B, C, D and E). Cases which were not classified in any of these subgroups were considered as F. The surgeon also determined the position of the impacted teeth after surgery based on the mentioned classification. To assess the correlation of the data, Kappa analysis was used. Results: Kappa statistics for agreement between radiography and surgery was 0.85 (p<0.001). Conclusion: According to this study, radiological assessment before third molar tooth surgery can reduce the risk of conceivable damage to the canal and nerve. It is recommended to consider the radiologists opinion before surgery.