Use of CBCT and panoramic radiography in the prediction of alterations in sensivity of the inferior alveolar nerve in third molars: A retrospective cross-sectional study

Objectives: We investigated which type of orthopantomography (OPG) was best able to predict neurological alterations of the inferior alveolar nerve (IAN) during extraction of a lower third molar (3 M). Methods: We analysed cone beam computed tomographies (CBCTs) that were performed at a private dental clinic in Cartagena, Spain over five consecutive years. The CBCTs, together with their corresponding OPGs, had been prescribed for the surgical extraction of a lower 3 M. Results: We analysed a total of 342 CBCTs and their corresponding OPGs. After explaining the risk of changes in the IAN sensitivity, 37 patients refused to undergo surgical extraction. The incidence of sensitivity alterations in the 332 dental extractions was 62 (19%): 44 were paraesthesias of the IAN, and 18 were associated with darkening of the root and interruption of the cortical line. Conclusion: When an OPG revealed darkening of the root and interruption of the cortical line, the risk of contact between the lower 3 M and the IAN-that is, the probability of changes in IAN sensitivity-increased by over three-fold.