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Potential reformatting errors in cone-beam computed tomography for dentoalveolar surgery: a cautionary tale
Jonathan L Jones1, Jeremy Knox2, Steven J Key3
1Oral and Maxillofacial Specialist Registrar, Oral and Maxillofacial Surgery Department, Morriston Hospital, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL.
The British Journal of Oral & Maxillofacial Surgery
|June 1, 2016
Summary
Preoperative imaging suggested the inferior alveolar nerve (IAN) was encased by a lower second molar root. However, during surgery, the nerve was found to be separate, highlighting risks of over-reliance on imaging for dentoalveolar surgery.
Area of Science:
- Dentistry
- Oral Surgery
- Radiology
Background:
- Cone-beam computed tomography (CBCT) is increasingly used for treatment planning in dentoalveolar surgery.
- Accurate visualization of anatomical structures like the inferior alveolar nerve (IAN) is crucial for surgical safety.
Observation:
- A case involving the planned removal of a lower second molar is presented.
- Preoperative CBCT indicated the IAN was encased within the distal root apex.
- Surgical exploration revealed the IAN was entirely separate from the tooth root apex.
Findings:
- The preoperative CBCT assessment of the IAN's relationship to the second molar root was inaccurate.
- Intraoperative findings contradicted the imaging predictions regarding nerve proximity.
Implications:
- This case serves as a cautionary example regarding the limitations of relying solely on imaging and software for surgical decision-making.
- Clinicians must integrate imaging data with clinical judgment during dentoalveolar surgery planning.
- Over-reliance on technology without considering potential discrepancies can lead to unexpected intraoperative findings.
