Hallazgos Imaginológicos que Indican la Proximidad de Raíces de Terceros Molares Inferiores con el Canal Mandibular: Revisión de la Literatura
DOI:
https://doi.org/10.21270/archi.v11i1.5456Palabras clave:
Radiografía Panorámica, Tomografía Computarizada de Haz Cónico, Tercer Molar, Nervio MandibularResumen
La radiografía panorámica (RP) es la prueba de imagen más utilizada para evaluar la relación entre las raíces del tercer molar inferior (TMI) con el canal mandibular (CM), sin embargo, la tomografía computarizada de haz cónico (TCHC) también puede estar indicada con la misma propósito, teniendo la ventaja de permitir un análisis tridimensional de la región. El objetivo de este estudio fue realizar un relevamiento bibliográfico sobre los signos radiográficos que indican una estrecha relación entre la raíz dentaria del TMI con el CM en el RP y TCHC. Las búsquedas se realizaron en PubMed, Medline y Lilacs utilizando los siguientes descriptores: radiografía panorámica, nervio mandibular, tercer molar, tomografía computarizada de haz cónico. Se realizó una lectura completa de los textos compatibles con los objetivos, excluyendo aquellos en los que el CM no tuvo contacto íntimo con las raíces del TMI en los exámenes de imagen, reportes de casos clínicos y artículos que utilizaron radiografías periapicales para observar tal relación. Las señales radiográficas más relevantes para evaluar la relación raíz / conducto mandibular fueron: interrupción de la línea blanca del conducto, oscurecimiento de la raíz, desviación / estrechamiento del conducto, así como signos tomográficos que incluyen ausencia de corticalización, posición del nervio lingual y forma anatómica del canal (desgarro y mancuerna), como predictores de mayor riesgo de daño nervioso. Se concluye que el examen de elección para valorar la proximidad del TMI con el CM sigue siendo el RP, considerando que presenta signos fiables, menor dosis de radiación y coste con respecto al TCHC.
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