Lingual plate thickness influences cortical bone injury during lower third molar extraction: A cone beam computed tomography study.

PURPOSE: To determine which factors influence lingual plate injury during the extraction of mandibular third molars, using cone beam computed tomography (CBCT) analysis, considering tooth position and lingual plate morphology.

METHODS

This retrospective study included CBCT images of 35 mandibular third molars taken preoperatively and seven days post-extraction. The images were obtained from a previous prospective clinical trial investigating bone healing. In the preoperative images, six parameters were evaluated: lingual plate thickness, impaction depth, mesiodistal and buccolingual angulation, lingual plate morphology, and the topographic relationship between the root apex and the lingual plate. In the postoperative images, the lingual plate was classified as either intact or fractured. Statistical analysis was performed using logistic regression to assess the influence of the different variables on lingual plate damage.

RESULTS

CBCT images of 35 mandibular third molars were analyzed. Logistic regression analysis revealed that lingual plate thickness at the level of the cementoenamel junction significantly influenced the likelihood of plate fracture during extraction (95% CI: -1.19 to -0.20; p =.007).

CONCLUSION

Understanding lingual plate thickness variations can aid in surgical planning and reduce intraoperative complications in lower third molars extraction. CBCT may be particularly useful in cases involving complex impactions.

CLINICAL TRIAL NUMBER: The clinical trial from which the CBCT images were obtained was registered in the Brazilian Registry of Clinical Trials (REBEC) under number U1111-1263-9675.