title: Risk assessment of inferior alveolar neurovascular bundle by multidetector computed tomography in extractions of third molars.
abstract: OBJECTIVE
  This study aimed to assess the reliability of multidetector computed tomography (MDCT) in determining the surgical risk of the inferior alveolar neurovascular bundle in extractions of third molars.
  
  
  METHODS
  The sample comprised thirty-three individuals (63 third molars) who underwent preoperative evaluation by MDCT before extraction of impacted mandibular third molars. MDCT was used to determine the relationship between the roots of the third molars and the mandibular canal, and the course of the mandibular canal. Inferior alveolar nerve (IAN) exposure and the presence of hemorrhage were analyzed after removal of the teeth. IAN neurosensory deficit was recorded after 7 days. Clinical and MDCT findings were compared using Fisher's exact test (P < 0.05).
  
  
  RESULTS
  There was a statistically significant association between IAN exposure and the tomographic relationship between the roots of third molars and the mandibular canal (P = 0.015). Conventionally, all cases of IAN neurosensory deficit and hemorrhage occurred when the roots of the third molar presented in an at-risk relationship with the mandibular canal, however, this association was not statistically significant (P > 0.05). A statistically significant association was found between the lingual course of the mandibular canal and IAN exposure (P = 0.03).
  
  
  CONCLUSIONS
  MDCT is an effective tool for determination of the surgical risk to the inferior alveolar neurovascular bundle in extraction of mandibular third molars.
authors.affiliation: Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Cx Postal 52, Piracicaba, São Paulo, 13414-903, Brazil. fredsampaio@yahoo.com.br
authors.forename: Frederico Sampaio
authors.initials: FS
authors.lastname: Neves
authors.forename: Solange Maria
authors.initials: SM
authors.lastname: de Almeida
authors.forename: Frab Norberto
authors.initials: FN
authors.lastname: Bóscolo
authors.forename: Francisco
authors.initials: F
authors.lastname: Haiter-Neto
authors.forename: Marcelo Corrêa
authors.initials: MC
authors.lastname: Alves
authors.forename: Iêda
authors.initials: I
authors.lastname: Crusoé-Rebello
authors.forename: Paulo Sérgio Flores
authors.initials: PS
authors.lastname: Campos
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D018570:Risk Assessment; D036542:Tomography, Spiral Computed / Q000379:methods*; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*; D061221:Trigeminal Nerve Injuries / Q000000981:diagnostic imaging*