Influence of cone beam computed tomography versus panoramic radiography on the surgical technique of third molar removal: a systematic review

Panoramic radiography is the standard imaging method for preoperative assessment before lower third molar removal. However, oral surgeons have been using cone beam computed tomography (CBCT) as an additional tool to assess detailed preoperative data, as it provides cross-sectional images. The aim of this systematic review was to determine whether the use of CBCT and the additional information provided modifies the preoperative assessment of lower third molar removal when compared to panoramic radiography and consequently results in a different surgical approach. A search of the PubMed, Embase, Web of Science, Science Direct, and Scopus electronic databases was performed on 30 June 2018, which retrieved 196 records without duplicates. The grey literature was also searched to include any other paper that might meet the eligibility criteria, which resulted in an additional five records. Among these papers, five met all of the eligibility criteria. These five studies included a total of 289 individuals and a total sample of 311 teeth. The findings showed that three-dimensional imaging does not change the surgical approach when compared to panoramic radiography; however it is considered a useful imaging method to understand the relationship between the lower third molars and the mandibular canal.