Preoperative imaging procedures for lower wisdom teeth removal

The aims of this paper were to critically review the role of radiographic imaging before lower third molar removal and to suggest a strategy for preoperative imaging based on available scientific evidence and clinical experience. Original articles and reviews including the MESH terms third molar and radiography were selected from the Medline database. Other sources were taken from references of selected papers. It was found that the scientific evidence on the usefulness of different preoperative imaging techniques of wisdom teeth is low. Therefore, information gathered from the literature was combined with the authors' clinical experience to suggest a strategy for preoperative imaging of lower third molars. Currently available radiological techniques used for preoperative imaging of lower third molars are also presented. It is suggested that panoramic and/or intraoral radiographs are sufficient as preoperative imaging in the vast majority of cases where there is no overlap between the mandibular canal and the wisdom tooth. Supplement with a posteroanterior open mouth projection will solve most of the remaining cases. In a restricted number of cases where there is an intimate relationship between the mandibular canal and the wisdom tooth, volume tomography such as cone beam computed tomography or low-dose computed tomography is indicated.