3D imaging reconstruction and impacted third molars: case reports

There is a debate in the literature about the need for Computed Tomagraphy (CT) before removing third molars, even if positive radiographic signs are present. In few cases, the third molar is so close to the inferior alveolar nerve that its extraction might expose patients to the risk of post-operative neuro-sensitive alterations of the skin and the mucosa of the homolateral lower lip and chin. Thus, the injury of the inferior alveolar nerve may represent a serious, though infrequent, neurologic complication in the surgery of the third molars rendering necessary a careful pre-operative evaluation of their anatomical relationship with the inferior alveolar nerve by means of radiographic imaging techniques. This contribution presents two case reports showing positive radiographic signs, which are the hallmarks of a possible close relationship between the inferior alveolar nerve and the third molars. We aim at better defining the relationship between third molars and the mandibular canal using Dental CT Scan, DICOM image acquisition and 3D reconstruction with a dedicated software. By our study we deduce that 3D images are not indispensable, but they can provide a very agreeable assistance in the most complicated cases.