Pérez-González, FSánchez-Labrador, LCortés Bretón Brinkmann, JorgeSáez-Alcaide, L-MBazal-Bonelli, SMadrigal Martínez-Pereda, Cristina MaríaLópez-Quiles Martínez, Juan2025-01-202025-01-202024-01Pérez-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.260561698-444710.4317/medoral.26056https://hdl.handle.net/20.500.14352/115044Background: 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.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal article1698-6946https://doi.org/10.4317/medoral.2605637992147https://pmc.ncbi.nlm.nih.gov/articles/PMC10765331/https://pubmed.ncbi.nlm.nih.gov/37992147/open access616.314-089616-073611.8Impacted lower third molarInferior alveolar nerveSensitivity alterationsPanoramic radiographsCone bean computed tomographyCirugía bucofacialDiagnóstico por imagen y medicina nuclearNeurociencias (Medicina)3213.13 Ortodoncia-Estomatología3213 Cirugía2209.90 Tratamiento Digital. Imágenes2410.09 Neuroanatomía Humana