None listed
Conditions
Brief summary
A known risk factor for lower wisdom teeth removal is inferior alveolar nerve injury, due to the anatomical position and relationship of these two structures. Patients who are referred for wisdom teeth removal routinely have an orthopantomogram for preoperative assessment of these teeth. Cone beam scan, which is a low dose computed tomography scan providing 3-dimension representation of the site, is becoming increasingly popular for inferior alveolar nerve localization. However, there are no studies to show that additional scanning improves outcomes and decreases risk of post-operative numbness for the patient. Furthermore, there are currently no guidelines regarding clear indications for the use of cone beam scan as an adjunct. This project will look at the incidence of postoperative altered inferior alveolar nerve sensation in patients who have lower wisdom teeth removed – in groups where they have the routine orthopantomogram radiograph only, and those who have, in addition to the orthopantomogram radiograph, a cone beam scan. The project will aim to establish evidence based guidelines for the use of Cone beam scan imaging as an adjunctive tool for third molar surgery. Patients who agree to take part in the project will be randomised into two groups – the control is the group without additional imaging ("orthopantomogram only" group), and the intervention group is the group with the additional cone beam scan ("orthopantomogram and Cone beam scan" group). The imaging will be examined with respect to the relationship between the inferior alveolar nerve and lower wisdom teeth. During routine post-operative visits, patients are routinely monitored to establish the presence of inferior alveolar nerve injury. This data will be collected and analysed.
Interventions
Patients participating in study (patients for lower wisdom teeth removal) will be randomised into two groups:
1- OPG (orthopantomogram) only as the preoperative imaging(gold standard)
2- OPG (orthopantomogram) and cone beam scan as the preoperative imaging
The intervention is: requesting an additional scan (Cone Beam Scan) of the third molar area
The duration of intervention is approximately 5-10 mins (ie the duration to set up and take a cone beam scan is ~5-10mins) - ONLY one scan ie one sessi
Patients participating in study (patients for lower wisdom teeth removal) will be randomised into two groups: 1- OPG (orthopantomogram) only as the preoperative imaging(gold standard) 2- OPG (orthopantomogram) and cone beam scan as the preoperative imaging The intervention is: requesting an additional scan (Cone Beam Scan) of the third molar area The duration of intervention is approximately 5-10 mins (ie the duration to set up and take a cone beam scan is ~5-10mins) - ONLY one scan ie one session. Period of follow up is as per standard protocol for postoperative wisdom teeth follow up, that is: at 2 weeks postoperatively, if any concerns then at 3-4 weeks postop, if residual paraesthsia then 3months postop, then at 6months postop. If no paraesthesia and no problems after 2 weeks then patients are discharged.
Sponsors
Royal Dental Hospital Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria for recruitment of patients is that of a convenience population – male and female patients over 18 years of age requiring lower wisdom teeth removal, who consent to participating in the study
Exclusion criteria
Exclusion critieria include: pregnant patients, patients incapable of consenting, patients wtih jaw pathology, preexisting paraesthesia, where on OPG the distance between the inferior alveolar nerve and lower third molar is >5mm
Outcome results
None listed