The neuronal feedback (NF) technique in third molar surgery

Mandibular third molars (M3M) could present themselves in close proximity to inferior alveolar nerve (IAN). Execution of tooth displacement and extraction of third molar roots may result in nerve injuries: neuronal lesions have a frequency that ranged from 0.5% to 8% during surgery of M3M in close proximity to IAN. Computed tomography (CT) scans are widely used to deter- mine the spatial relation between the IAN and lower third molars. Recently, coronectomy has been introduced for intentional M3M partial removal, in order to avoid IAN lesion, but often a second intervention in years is required and possibility of many complications exists in the post-surgical time, so complete surgical extraction of M3M in close proximity to IAN and presurgical imaging study evaluation are still a matter of interest in international literature. In this sight, we performed a fine literature review considering the possibility of the use of a neuronal feedback (NF) of the patient during M3M surgery in order to completely extract M3M and avoid IAN lesions, and we theorized a new surgical technique for extraction of M3M in close proximity to IAN, requiring the use of CT-scan presurgical study and a particular anesthesia technique. In this paper, the authors describe a new surgical technique and the outcome on patients requiring M3M surgery in communication with IAN. Recovery of patients has been measured with Health-Related Quality of Life (HRQOL) parameters.