{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:20:53Z","timestamp":1782890453657,"version":"3.54.5"},"reference-count":17,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Aim: This study aimed to evaluate the impact of cone beam computed tomography (CBCT) on preoperative surgical decision-making and risk assessment for mandibular third molar (MM3) extractions in cases identified as high-risk by orthopantomography (OPG). Materials and Methods: This prospective observational diagnostic study utilized the purposive sampling method, recruiting 50 MM3s from 33 patients (21 females, 12 males; mean age 24.24 \u00b1 6.77 years, range 16\u201342). Samples were categorized into five distinct radiographic groups based on the proximity of roots to the inferior alveolar nerve (IAN) on OPG. The methodology involved a comparative 3D analysis to determine neurovascular contact, spatial orientation, and the presence of a cortical border. Surgical strategies, specifically the necessity for coronectomy or the lingual split technique, were reassessed following 3D evaluation. Postoperative neurosensory outcomes were recorded. Statistical analysis was performed using the Fisher\u2013Freeman\u2013Halton and Kruskal\u2013Wallis tests. Results: CBCT identified direct IAC contact in 74% of the cases. In 18% of the cases initially deemed high-risk by OPG, CBCT revealed a safe distance, thereby altering the surgical approach. Tooth angulation (p = 0.012) and Pell and Gregory classification (p = 0.024) were significant predictors of contact. Temporary neurosensory disturbances occurred in 4% (n = 2) of the sample, specifically in cases where CBCT had confirmed the loss of nerve canal cortication. Conclusions: In accordance with the study aim, CBCT provides essential 3D data that refines surgical planning in nearly one-fifth of high-risk cases. The findings justify selective CBCT use, guided by the ALADA principle, to minimize iatrogenic injury.<\/jats:p>","DOI":"10.3390\/tomography12070097","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T03:06:34Z","timestamp":1782875194000},"page":"97","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Cone Beam Computed Tomography on Surgical Decision-Making and Risk Assessment in Mandibular Third Molar Extractions: A Prospective Observational Diagnostic Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2899-2260","authenticated-orcid":false,"given":"Fatma Hande","family":"Aktemur G\u00fcrkan","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul 34015, Turkey"},{"name":"Department of Oral and Maxillofacial Surgery, Biruni University Dental Hospital, Merkezefendi Mah., G\/75 Sk. No: 1-13, Istanbul 34015, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Cenk","family":"Durmu\u015flar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul 34015, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00276-017-1928-6","article-title":"Anatomic study of the position of the mandibular canal and corresponding mandibular third molar on cone-beam computed tomography images","volume":"40","author":"Gu","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s13005-021-00271-5","article-title":"Does a preoperative cone beam ct reduce complication rates in the surgical removal of complex lower third molars? 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(2022). Does the addition of cone-beam ct to panoral imaging reduce inferior dental nerve injuries resulting from third molar surgery? A systematic review. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02490-x"}],"container-title":["Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2379-139X\/12\/7\/97\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:40:16Z","timestamp":1782884416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2379-139X\/12\/7\/97"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["tomography12070097"],"URL":"https:\/\/doi.org\/10.3390\/tomography12070097","relation":{},"ISSN":["2379-139X"],"issn-type":[{"value":"2379-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}