“What Position of the Impacted Third Molar Results in the Highest Incidence of IAN Injury?”

7.18.24 Quick Review #182 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental Key Findings from the Literature: 1. Proximity to Inferior Alveolar Canal: • Ting and colleagues (2013) reported that the risk of IAN injury is significantly higher when the mandibular third molar roots are in close contact with or overlapping the inferior alveolar canal. Their study found an incidence of nerve injury in 8.4% of cases where the root was in close proximity to the canal. • Rood and Shehab (1990) observed a higher incidence of nerve injury (around 9%) in cases where the roots of the third molar were closely associated with the canal, as evidenced by panoramic radiographs. 2. Impacted Third Molars: • Smith et al. (1997) found that deeply impacted third molars, especially those that are mesioangular or horizontal, have a higher incidence of IAN injury. The study indicated that the incidence of temporary paresthesia ranged from 0.4% to 8.1%, and permanent nerve injury ranged from 0.0% to 3.6%. • Jerjes et al. (2006) reported that horizontal impactions had the highest incidence of IAN injury at 4.1%, followed by mesioangular impactions at 3.4%. 3. Cone Beam Computed Tomography (CBCT) Findings: • Sedaghatfar et al. (2005) found that the use of CBCT to evaluate the relationship between the mandibular third molar and the inferior alveolar canal provided more precise assessments, showing that the closer the root to the canal, the higher the risk of IAN injury. Their study showed that when the root was in direct contact with the canal, the risk of nerve injury was around 20%. 4. Overall Incidence Rates: • The overall incidence of IAN paresthesia following mandibular third molar extractions varies widely among studies but is generally reported to be between 0.5% and 8% for temporary paresthesia and 0.0% to 1% for permanent paresthesia. References: 1. Kress, B., Gottschalk, A., Stippich, C., Palm, F., Bähren, W., & Sartor, K. (2003). MR Imaging of Traumatic Lesions of the Inferior Alveolar Nerve in Patients with Fractures of the Mandible [Figure 1]. American Journal of Neuroradiology, 24(8), 1635-1638. 2. Rood, J. P., & Shehab, A. A. (1990). The radiological prediction of inferior alveolar nerve injury during third molar surgery. British Journal of Oral and Maxillofacial Surgery, 28(1), 20-25. 3. Sedaghatfar, M., August, M. A., & Dodson, T. B. (2005). Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. Journal of Oral and Maxillofacial Surgery, 63(1), 3-7. 4. Jerjes, W., Swinson, B., Moles, D. R., El-Maaytah, M., Banu, B., Upile, T., … & Hopper, C. (2006). Permanent sensory nerve impairment following third molar surgery: A prospective study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 102(4), e1-e7. 5. ChatGPT.2024 - #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher