Prevalencia de relación anatómica entre tercer molar inferior y conducto dentario inferior en pacientes tratados en la clínica odontológica, Universidad Andrés Bello, Concepción, 2013-2016
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2016
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es
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Universidad Andrés Bello
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Antecedentes: La extracción de terceros molares, impactados o ectópicos, es una de las acciones quirúrgicas más frecuentes y no está exento de complicaciones, siendo el daño al nervio dentario inferior (NDI) uno de los más severos, con una incidencia que varía entre el 0,26% y el 22%, con daño irreversible en menos del 1% de los casos. Debido a la cercanía de estas estructuras, su diagnóstico con la imagen 2D obtenida de una radiografía panorámica de rutina es limitado, por lo que una Tomografía Computarizada Cone Beam (CBCT) nos entrega mayor información para determinar su posición real.
Justificación: La importancia de conocer la prevalencia de la relación anatómica entre ambas estructuras se fundamenta en la necesidad de poder planificar y abordar de manera eficaz la exodoncia de los terceros molares inferiores limitando los riesgos de daño al nervio dentario inferior.
Objetivo: Determinar la prevalencia de relaciones anatómicas entre el tercer molar inferior y el conducto dentario inferior, en pacientes atendidos en la clínica odontológica de la Universidad Andrés Bello, Concepción, 2013 – 2016.
Material y método: Se realizó un estudio observacional: de prevalencia; retrospectivo, transversal, analítico, en pacientes atendidos en la clínica odontológica de la Universidad Andrés Bello, Concepción, en el periodo 2013 – 2016. La muestra correspondió al universo, correspondiente al análisis radiológico de 121 terceros molares inferiores pertenecientes a 77 pacientes. Se examinó datos del paciente como sexo, edad, pieza, clasificación de Pell y Gregory, Winter y Wang según lo observado en los CBCT. Los resultados obtenidos fueron procesados con el software IBM SPSS v23 y analizados con métodos estadísticos descriptivos e inferenciales, utilizando pruebas de asociación Ji2 y V de Cramer, todos con α=0,05. Resultados observados: Del total de 77 pacientes evaluados, el promedio de edad fue de 33,3 ± 13,8 años, el 35,1% correspondieron al sexo masculino y 64,9% al sexo femenino. Se concluyó que la prevalencia de la relación entre el tercer molar inferior y el conducto dentario inferior alcanza 33,3% y 29,3% para los lados izquierdo y derecho respectivamente, en posiciones de contacto. Por otra parte, la posición del conducto dentario respecto al tercer molar inferior se asoció significativamente a la posición de éste según la clasificación de Pell y Gregory y Winter.
Background: The surgical removal of impacted mandibular third molars is one of the most frequent surgical procedures and it is not without complications, with the injury of the Inferior Alveolar Nerve (IAN) being one of the most severe, with an incidence of 0,26% and 22%, and irreversible in less than 1% of cases. Diagnosis is limited with a routine panoramic radiography 2D image, being a Cone Beam Computed Tomography (CBCT) needed in most cases to determine the real position. Justification: The importance of knowing the prevalence of this anatomical relation is based on the need for planning and effective surgical approach in the surgical removal of mandibular third molar without injury of the inferior alveolar nerve. Purpose: To determine the prevalence of the anatomical relation between the mandibular third molar and the mandibular canal, in patients treated at the Andrés Bello University Dental Clinic in Concepción, between years 2013 and 2016. Material and methods: An observational, prevalence; retrospective, transversal and analytic study was performed in patients treated at the Andrés Bello University Dental Clinic. The sample correspond to the universe, consisting in 121 mandibular third molars of 77 patients. A chart is completed with patient’s data, gender, age, tooth, Pell & Gregory’s, Winter’s and Wang’s classifications, according observations of each CBCT. The data obtained was processed with the software IBM SPSS Statistics v.23 and analysed with association inferential statistics techniques, with the purpose of evaluate association, Chi-square test and correlation with Cramer’s V were used, considering α=0,05 in all cases. Results: Of the 77 patients, the mean age was 33,3 ± 13,8 years, 35,1% were male and 64,9% were female. The relation between mandibular third molar and mandibular canal prevalence got to 33,3% and 29,3% to the left and right side. respectively, to contact positions, was concluded. On the other hand, the mandibular canal position respect the mandibular third molar was significantly linked with the molar position according Pell & Gregory’s and Winter’s classifications.
Background: The surgical removal of impacted mandibular third molars is one of the most frequent surgical procedures and it is not without complications, with the injury of the Inferior Alveolar Nerve (IAN) being one of the most severe, with an incidence of 0,26% and 22%, and irreversible in less than 1% of cases. Diagnosis is limited with a routine panoramic radiography 2D image, being a Cone Beam Computed Tomography (CBCT) needed in most cases to determine the real position. Justification: The importance of knowing the prevalence of this anatomical relation is based on the need for planning and effective surgical approach in the surgical removal of mandibular third molar without injury of the inferior alveolar nerve. Purpose: To determine the prevalence of the anatomical relation between the mandibular third molar and the mandibular canal, in patients treated at the Andrés Bello University Dental Clinic in Concepción, between years 2013 and 2016. Material and methods: An observational, prevalence; retrospective, transversal and analytic study was performed in patients treated at the Andrés Bello University Dental Clinic. The sample correspond to the universe, consisting in 121 mandibular third molars of 77 patients. A chart is completed with patient’s data, gender, age, tooth, Pell & Gregory’s, Winter’s and Wang’s classifications, according observations of each CBCT. The data obtained was processed with the software IBM SPSS Statistics v.23 and analysed with association inferential statistics techniques, with the purpose of evaluate association, Chi-square test and correlation with Cramer’s V were used, considering α=0,05 in all cases. Results: Of the 77 patients, the mean age was 33,3 ± 13,8 years, 35,1% were male and 64,9% were female. The relation between mandibular third molar and mandibular canal prevalence got to 33,3% and 29,3% to the left and right side. respectively, to contact positions, was concluded. On the other hand, the mandibular canal position respect the mandibular third molar was significantly linked with the molar position according Pell & Gregory’s and Winter’s classifications.
Notas
Tesis (Cirujano Dentista)
Palabras clave
Terceros molares, Conducto dentario, Tomografía Computarizada Cone Beam, Región del Bío Bío, Comuna de Concepción