Radiographic tips on predicting inferior alveolar nerve exposure
O Ross Beirne1, Philippe Hujoel
1Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, WA 98195, USA. slsb@u.washington.edu
Subjects:
The study included 230 patients (60% female) with a total of 423 wisdom tooth extractions. The patients were treated by 2 oral surgeons between July 1998 and July 2002 in the Oral and Maxillofacial Surgery Unit of the Massachusetts General Hospital in Boston, Massachusetts.
Gold Standard:
The authors reported that the extraction was inspected for evidence of inferior alveolar nerve (IAN) exposure under direct vision using a headlight.
Diagnostic Tests:
Each tooth was inspected for the presence of any of the following 5 radiographic signs:
Main Results:
No IAN exposures occurred when all 5 radiographic signs were absent. Based on this study, where 189 M3 had such a radiographic presentation, we can conclude that the upper limit of the 95% confidence interval for the IAN exposure is 1.6%. None of the 5 diagnostic markers, when used in isolation, had adequate sensitivity and specificity to accurately predict an IAN nerve exposure in a clinical setting.
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