Does Computed Tomography Prevent Inferior Alveolar Nerve Injuries Caused by Lower Third Molar Removal?

Purpose: To verify the utility of computed tomography (CT) in preventing inferior alveolar nerve (IAN) injury owing to lower third molar extraction in close relation to the IAN on orthopantomogram. Materials and Methods: A retrospective cohort study design of 150 lower third molar extractions was performed. Patients were divided in 2 groups: the CT group (n = 95) underwent panoramic radiography and mandibular CT and the control group (n = 55) underwent only panoramic radiography. Results: Six extractions (4%) in the control group and 15 (10%) in the CT group resulted in IAN impairment (P > .05). Logistic regression models did not show that undergoing CT decreased the risk of IAN injury from lower third molar extraction. Conclusions: Patient age and positive radiographic signs (darkening of the root and narrowing of the inferior alveolar canal) were associated with more requests for CT scanning. CT does not seem to significantly decrease the risk of producing IAN injury. (C) 2012 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 70: 5-11, 2012