Tomographic assessment of the position of the inferior alveolar nerve in relation to the lower third molars

Resumo

Third molars are the most frequently included or impacted teeth, with the highest incidence in the mandible. Surgical removal of these teeth requires careful preoperative assessment. Although panoramic radiography is widely used, its limitations include distortion and overlapping of structures. Cone beam computed tomography (CBCT) offers three-dimensional images, providing a more detailed analysis, especially for cases where there is a risk of injury to the inferior alveolar nerve (IAN). Objective: Therefore, the aim of this study was to evaluate the relationship between the position of the IAN and mandibular third molars, using CBCT scans taken from March 2023 to March 2024. Results: Of the 97 CBCTs evaluated, 91 were included. The trajectory inferior to the third molar was the most prevalent (28%), with contact with the IAN in 69% of cases. There was narrowing of the mandibular canal in 57% of the images and absence of cortical bone in 58%. The mesioangular position was the most frequent (39%) and the retromolar canal appeared in 4.4% of cases. Conclusion: However, these findings reinforce the importance of CBCT in surgical planning, allowing an accurate assessment of the relationship between the third molar and the IAN in order to reduce risks and complications.