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Diagnostic accuracy of CBCT compared to panoramic radiography in predicting IAN exposure: a systematic review and meta-analysis

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Abstract

Objectives

The aim of this study is to verify whether the diagnostic accuracy of cone beam computed tomography (CBCT) is superior to panoramic radiography (PR) in predicting inferior alveolar nerve (IAN) exposure during the lower third molar extraction.

Materials and methods

Eight electronic databases were searched up to September 2020. Studies that evaluated the accuracy (sensitivity, specificity, positive-predictive value, and negative predictive value) of both imaging methods were included. The gold standard was the visualization of the IAN exposure during the extraction of lower third molars. The gray literature was also used to include any other paper that might meet the eligibility criteria. The meta-analysis was performed with OpenMeta-Analyst and ReviewManager v.5.3 software. The methodology of the studies was evaluated using QUADAS-2.

Results

Among the search, three studies met all the eligibility criteria and were included in the qualitative and quantitative synthesis. The meta-analysis was conducted with all included studies. Accuracy values for CBCT were 95.1% for sensitivity (p=0.666) and 64.4% for specificity (p<0.001). For PR sensitivity and specificity, we observed 73.9% (p=0.101) and 24.8% (p<0.001), respectively.

Conclusions

Both exams were reliable for detecting positive cases of exposure of the IAN. However, CBCT had a better performance compared to PT in predicting IAN exposure during surgery.

Clinical relevance

To better understand the CBCT accuracy in predicting the IAN exposure during surgery, since this event can increase the likelihood of IAN injury and, consequently, cause neurosensory disturbances.

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Funding

This study was Financed in part  by the Coordenação deAperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) - Finance Code 001.

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Authors and Affiliations

  1. Department of Surgery, Stomatology, Pathology, and Radiology, Bauru School of Dentistry, University of São Paulo, Alameda Octávio Pinheiro Brisola, 9-75, Bauru, São Paulo, 17012-901, Brazil

    Veronica Caroline Brito Reia , Mariela Peralta-Mamani , Mariel Ruivo Biancardi , Cássia Maria Fischer Rubira  & Izabel Regina Fischer Rubira-Bullen

  2. School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil

    Gabriel de Toledo Telles-Araujo

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  1. Veronica Caroline Brito Reia
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  5. Cássia Maria Fischer Rubira
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Correspondence to Izabel Regina Fischer Rubira-Bullen.

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Reia , V.C.B., de Toledo Telles-Araujo , G., Peralta-Mamani , M. et al. Diagnostic accuracy of CBCT compared to panoramic radiography in predicting IAN exposure: a systematic review and meta-analysis. Clin Oral Invest 25, 4721–4733 (2021). https://doi.org/10.1007/s00784-021-03942-4

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