Indicação de exames imaginológicos para terceiros molares inferiores: uma revisão de literatura

Abstract

Dental extraction is a common procedure in dental offices; however, it is a complex intervention that may result in injuries to the patient. For safe and effective surgical planning, imaging exams are essential as they complement the clinical examination and help assess the position of the third molars in the oral cavity, their relationship with other teeth and/or anatomical structures, as well as identifying any associated pathologies. The main exams used for this analysis include periapical radiographs, panoramic radiographs, and computed tomography. Although the literature on the subject is extensive, dental surgeons still face challenges in the accurate indication of these exams. Thus, the objective of this work was to conduct an updated literature review regarding the imaging exams that can be used to assess the position of lower third molars (LTM), aiming to clarify the criteria for requesting exams and contribute to a more precise and evidence-based approach in dental practice. The bibliographic research was conducted in the PubMed database, utilizing systematic reviews and metaanalyses, without a period restriction, with the keywords: “third molar” AND “computed tomography,” “radiography,” and “panoramic radiography.” The included studies indicated that the choice of exam should prioritize minimizing the radiation dose to the patient. When the periapical radiograph is insufficient for assessment, the panoramic radiograph should be requested. In cases of difficulty in interpretation or suspicion of close contact between anatomical structures, computed tomography is the gold standard for the evaluation of LTM. Thus, careful selection of the imaging exam is crucial for ensuring safer surgical planning, reducing risks, and optimizing diagnosis in dental practice.