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Novel strategy to predict high risk of inferior alveolar nerve injury during extraction of lower third molars based on assessment of computed tomographic images of multiple anatomical features |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan;2. Department of Public Health, Sapporo Medical University School of Medicine, Japan;3. Department of Oral and Maxillofacial Surgery, Regional Independent Administrative Corporation Naha City Hospital, Japan;1. Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;2. Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait;3. Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl- Liebknecht Str. 145, 04277 Leipzig, Germany;4. Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;1. Master''s student in Orofacial Harmonization - European Face Institute, Porto, Portugal;2. Oral and Maxillofacial Surgeon, Master in Oral and Maxillofacial Surgery, PhD in Oral and Maxillofacial Sugery, Maxillofacial Program Director - European Face Institute, Porto, Portugal;1. University of Glasgow Medical School, University Avenue, Glasgow G12 8QQ, United Kingdom;2. Consultant Maxillofacial Head & Neck Surgeon, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow G51 4TF, United Kingdom;3. University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow G2 3JZ, United Kingdom;4. Specialty Registrar in Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow G51 4TF, United Kingdom |
| Abstract: | Preoperative assessment is essential to prevent inferior alveolar nerve (IAN) injury during surgical extraction of the lower third molar (LM3). Here, we aimed to establish an assessment system to predict IAN injury during surgical extraction of the LM3. We conducted a retrospective cohort study on 115 patients diagnosed as ‘high-risk’ based on our previous risk assessment method involving three anatomical features of the inferior alveolar canal using computed tomographic (CT) images. We evaluated the occurrence of neurosensory impairment in these high-risk patients, and its association with novel anatomic features based on CT images. Neurosensory impairments were observed in 19 patients (16.5%). The inferior alveolar canal major diameter (p < 0.0001) and lingual bone thickness (p = 0.0039) were significantly associated with the occurrence of neurosensory impairment during LM3 extraction. Receiver operating characteristic curves were used to determine cut-off values of these quantitative factors to specifically predict IAN injury. Preoperative risk assessment with quantitative factors based on anatomical features observed on CT images may facilitate more appropriate surgical planning for patients at a high risk of IAN injury. |
| Keywords: | Lower third molar Extraction Computed tomography Inferior alveolar nerve Inferior alveolar canal Neurosensory impairment |
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