Abstract
Aim: Estimating the risk of inferior alveolar nerve (IAN) injury prior to mandibular third molar extraction is crucial. Whether this estimation should be done using panoramic radiographs or cone beam computed tomography (CBCT) is still controversial. The aim of this study was to compare between the compatibility of digital panoramic radiographs and cone beam computed tomography findings in predicting IAN injury. Materials & Methods: In a retrospective study design, a chart review was conducted to identify mandibular third molar extraction cases imaged with CBCT and panoramic radiographs. Two calibrated oral and maxillofacial radiologists reviewed the CBCT images for signs of canal compression and two oral and maxillofacial surgeons reviewed the panoramic images for signs that increase the likelihood of IAN injury. Results: Interruption of the mandibular canal cortex as identified on panoramic radiographs was most consistent with CBCT results and predicting IAN injury regardless of age and gender. Narrowing of the roots and bifid roots, however, were least consistent with CBCT findings. Conclusion: Only some of the imaging signs that predict IAN injury in digital panoramic radiographs were consistent with canal compression findings on CBCT images. Further correlation with surgical findings is necessary. Clinical significance: These results bring us closer to understanding the difference in diagnostic information provided by digital panoramic radiographs (2D) and CBCT examinations (3D) and the influence of this information on predicting IAN injury prior to mandibular third molar extraction.