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Panoramic versus CBCT used to reduce inferior alveolar nerve paresthesia after third molar extractions: a systematic review and meta-analysis.

OBJECTIVES
The aim of this systematic review was to verify whether cone beam computed tomography (CBCT) in comparison with panoramic radiography reduced the cases of temporary paresthesias of the inferior alveolar nerve (IAN) associated with third molar extractions.


METHODS
The literature search included five databases (Pubmed, Scopus, Web of Science, Cochrane, SciELO), in addition to gray literature and hand search of reference list of included studies. Two reviewers independently screened titles/abstracts, and full texts according to eligibility criteria, extracted data and evaluated risk of bias through Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2.0). Data were meta-analyzed by comparing CBCT versus panoramic radiographs for number of events (temporary paresthesia after third molar surgery). Fixed effect was used for non-significant heterogeneity, relative risk (RR) and 95% confidence interval (CI) were calculated. The certainty of evidence was evaluated by GRADE (Grading of Recommendations, Assessment, Development, and Evaluation).


RESULTS
Four randomized controlled trials (RCTs) were included in meta-analysis, and for the majority of domains, they presented low risk of bias. RR was 1.23 (95% IC: 0.75-2.02; I2: 0%; p = 0.43) favoring panoramic radiography, but without significant effect, and with moderate certainty of evidence.


CONCLUSIONS
We concluded that both interventions had a similar ability to reduce temporary paresthesia of the IAN after third molar surgery with moderate certainty of evidence.