Achados Imaginológicos que Indicam Proximidade das Raízes de Terceiros Molares Inferiores com o Canal Mandibular: Revisão de Literatura
DOI:
https://doi.org/10.21270/archi.v11i1.5456Palavras-chave:
Radiografia panorâmica, Tomografia Computadorizada de Feixe Cônico, Terceiro Molar, Nervo MandibularResumo
A radiografia panorâmica (RP) é o exame de imagem mais utilizado para avaliar a relação entre as raízes do terceiro molar inferior (TMI) com o canal mandibular (CM), no entanto a tomografia computadorizada de feixe cônico (TCFC) também pode ser indicada com a mesma finalidade, tendo a vantagem de permitir uma análise tridimensional da região. O objetivo deste estudo foi realizar um levantamento bibliográfico sobre os sinais radiográficos que indicam relação de proximidade entre a raiz dentária do TMI com o CM na RP e TCFC. Buscas foram feitas no PubMed, Medline e Lilacs empregando os seguintes descritores: Radiography Panoramic, Mandibular Nerve, Molar Third, Cone-Beam Computed Tomography. Foi realizada a leitura completa dos textos compatíveis com os objetivos, excluindo àqueles em que o CM não apresentava íntimo contato com as raízes do TMI nos exames de imagens, relatos de casos clínicos e artigos que utilizaram radiográficas periapicais para observar tal relação. Os sinais radiográficos mais relevantes para avaliar a relação raiz/canal mandibular foram: interrupção da linha branca do canal, escurecimento da raiz, desvio/estreitamento do canal, bem como sinais tomográficos incluindo ausência de corticalização, posição lingual do nervo e formato anatômico do canal (lágrima e haltere), como preditores de maior risco para lesão nervosa. Conclui-se que o exame de eleição para avaliar a proximidade do TMI com o CM continua sendo a RP, tendo em vista que ela apresenta sinais confiáveis, menor dose de radiação e custo se comparado à TCFC.
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