RT Journal Article
T1 Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study
A1 Pérez-González, F
A1 Sánchez-Labrador, L
A1 Cortés Bretón Brinkmann, Jorge
A1 Sáez-Alcaide, L-M
A1 Bazal-Bonelli, S
A1 Madrigal Martínez-Pereda, Cristina María
A1 López-Quiles Martínez, Juan
AB Background: Surgical extraction of the lower third molar (LTM) may trigger neurosensory injury of the inferior alveolar nerve, making extraction a real challenge. This study set out to assess whether is it possible to predict neurosensory alterations from preoperative imaging.Material and methods: A total of 99 patients underwent 124 impacted lower third molar (ILTM) surgeries. Prior to surgery, panoramic and CBCT images were evaluated in an attempt to predict a neurosensory disturbance. Preoperative data (ILTM position, panoramic radiograph signs, inferior alveolar nerve (IAN) location and its contact with the ILTM roots) and intra/postoperative findings (extraction difficulty and sensitivity alterations) were recorded. Descriptive and bivariate data analysis was performed. Statistical comparison applied the chi-square test, Fisher test, and one-way ANOVA test. Statistical significance was established with a confidence interval (CI) of 95%.Results: In 4.03% of cases, patients experienced neurosensory alterations. Of 124 ILTM positions in panoramic radiographs, 76 cases were considered to exhibit a potential neurosensory risk as they presented two or more types of superimposed relationships between ILTM and mandibular canal. Of these, alterations were reported in only three cases (3.95%). Of the 48 remaining ILTM images presenting only one sign, neurosensory alterations were observed in two cases (4.17%). No permanent alterations were recorded in any of the five cases observed.Conclusions: Within the limitations of the present study, prediction of neurosensory alterations prior to ILTM extraction by means of preoperative imaging did not show a significant statistical correlation with post-surgical incidence. Nevertheless, interruption of the canal´s white line (ICWL) or a diversion of the canal (DC) may predict an increased risk of IAN injury.
PB Medicina Oral
SN 1698-4447
YR 2024
FD 2024-01
LK https://hdl.handle.net/20.500.14352/115044
UL https://hdl.handle.net/20.500.14352/115044
LA eng
NO Pérez-González F, Sánchez-Labrador L, Cortés-Bretón-Brinkmann J, Sáez-Alcaide LM, Bazal-Bonelli S, Madrigal-Martínez-Pereda C, López-Quiles J. Is it possible to predict neurosensory alterations in impacted lower third molar removal based on preoperative imaging procedures? A prospective cohort study. Med Oral Patol Oral Cir Bucal. 2024 Jan 1;29(1):e44-e50. doi: 10.4317/medoral.26056
DS Docta Complutense
RD 5 abr 2025