Radiographic Predictors of Postoperative Inferior Alveolar Nerve Injury in Mandibular Third Molar Surgery
Wan Zhi Tay1, Anton Sklavos2, Mustafa Mian3
1Resident, Department of Oral and Maxillofacial Surgery, Royal Dental Hospital Melbourne, Carlton, Victoria, Australia.
Summary
Panoramic X-rays reveal key signs predicting inferior alveolar nerve (IAN) paresthesia after mandibular third molar (M3M) surgery. Cone-beam CT did not significantly improve prediction accuracy for IAN nerve injury.
Area of Science:
- Oral and Maxillofacial Surgery
- Radiology
- Neurosurgery
Background:
- Cone-beam computed tomography (CBCT) offers 3D insights into mandibular third molar (M3M) and inferior alveolar nerve (IAN) proximity.
- CBCT use is increasing for preoperative M3M assessment.
Purpose of the Study:
- Compare radiographic findings from panoramic imaging and CBCT.
- Determine the association between these findings and postoperative IAN paresthesia.
Main Methods:
- Retrospective cohort study of patients undergoing impacted M3M removal.
- Analyzed OPG and CBCT features, including Rood and Shehab's signs, root morphology, impaction type, Pell and Gregory classification, IAN compression, and ankylosis.
- Used univariate and multivariate logistic regression to assess predictors of postoperative paresthesia.
Main Results:
- Panoramic features like canal narrowing, diversion, and dark/bifid roots were significantly associated with postoperative paresthesia.
- No CBCT features showed a significant association with postoperative paresthesia in multivariate analysis.
Conclusions:
- Specific panoramic radiographic features and patient age predict IAN paresthesia after M3M surgery.
- CBCT imaging did not significantly enhance the prediction of IAN paresthesia in this study.
