Does the Use of Cone Beam CT for Wisdom Teeth Removal Change the Surgical Approach Compared With Panoramic Radiography?

An interesting article titled “Does the Use of Cone Beam CT for the Removal of Wisdom Teeth Change the Surgical Approach Compared With Panoramic Radiography?” appears in the Sept. 2015 Journal of Oral Maxilofacial Surgery supplement (vol. 73, issue 9, pg. e12) written by S.P. Aravindaksha. The present study looked at  if the additional information provided by cone beam computed tomography (CBCT) images influences the surgical strategy in the
treatment of patients with impacted mandibular wisdom teeth in high-risk cases. The study sought to explore if there is any difference in risk assessment for inferior alveolar nerve (IAN) when using CBCT or panoramic radiography.

In the study patients with an increased risk of IAN injury, as diagnosed on panoramic radiographs, were enrolled in and underwent additional CBCT imaging. The study consisted of 52 impacted wisdom teeth from 36 patients (20 women and 16 men) with an average age of 24.6 years. Three board certified oral maxillofacial surgeons independently evaluated the panoramic radiographs in randomized order followed by the CBCT images. The surgeons were asked to answer questions based on the images.

Some inconsistencies were found across the surgeons for how well CBCT findings matched panoramic radiographic findings. Even so, the results showed that CBCT does not change the surgical planning and technique when compared with panoramic radiography. The author believes that a larger study is needed to prove any usefulness of CBCT in reducing IAN injury.

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