Prevalência da radiolucência justa-apical: um estudo em imagens de tomografia computadorizada de feixe cônico de uma população brasileira

Abstract

One of the main complications associated with the removal of third molars is injury of the inferior alveolar nerve (IAN). There are some well-established radiographic signs in the literature that indicates the proximity of the third molar to the mandibular canal, such as, darkening of the roots, deflection of the canal and interruption of the radiopaque cortical. However, most recently, a new sign has been described as possible risk factor to injury of the IAN: the juxta-apical radiolucency (JAR). This image is a well-defined radiolucent area localized laterally and in continuity to the apex of mandibular third molar. The aim of this study was to assess the prevalence of the JAR in cone beam computed tomography imaging of a Brazilian population, correlating with the gender and age of the patients, in addition to the side of involvement. In this retrospective study, 4,125 tomographic scans were analyzed, including those that had at least one healthy lower third molar. The final sample had 757 patients included and 1,232 mandibular third molars assessed. For data analysis, the Spearman coefficient was applied to correlate the JAR with the age of the patients and the chi-square test to correlate the JAR with the sex and the affected side. The prevalence found for JAR was 31.3%. It was not found any significant correlation between the JAR and the patient sex and affected side, but an association was observed between age and the presence of JAR, and the frequency of this structure decreases with increasing age. It can be concluded that the JAR is not a rare image, since its prevalence is higher than 30% in the studied population, being more common in young people. Moreover, it is necessary more prospective studies that can elucidate if there is a real relationship between the presence of the JAR and the higher risk of injury of the IAN in surgeries for removal of the mandibular third molars.