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Treatment Planning for Mandibular Third Molars.

James Barraclough, Andrew Power, Amit Pattni

    Dental Update
    |November 28, 2017
    PubMed
    Summary
    This summary is machine-generated.

    NICE guidance recommends limiting mandibular third molar surgery to symptomatic patients. This article proposes an algorithm to improve treatment planning and informed consent, considering risks like nerve injury and options such as coronectomy.

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    Area of Science:

    • Dentistry
    • Oral Surgery
    • Radiology

    Background:

    • NICE guidance since 2000 limits surgical treatment of mandibular third molars to symptomatic cases.
    • Surgical risks, including inferior alveolar and lingual nerve damage, necessitate careful patient explanation.
    • Predicting nerve injury risk aids treatment planning.

    Purpose of the Study:

    • To propose an algorithm for treatment planning and informed consent in mandibular third molar surgery.
    • To highlight the role of imaging in risk assessment.
    • To discuss coronectomy as a treatment option.

    Main Methods:

    • Review of NICE guidance and surgical complications.
    • Assessment of orthopantomogram (OPT) and cone beam computed tomography (CBCT) in predicting nerve injury.
    • Evaluation of coronectomy as a management strategy.

    Main Results:

    • OPT signs can predict increased risk of inferior alveolar nerve injury.
    • CBCT offers further assessment and influences treatment planning.
    • Coronectomy is a viable option for high-risk cases.

    Conclusions:

    • An algorithm can aid treatment planning and informed consent for mandibular third molar surgery.
    • Increased availability of CBCT and coronectomy expands patient treatment options.
    • This article assists dental practitioners in managing patients with problematic mandibular third molars.