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IntroductionSurgical removal of impacted third molars is maybe the most frequent procedure in oral surgery. Damage to the inferior alveolar nerve (IAN) is a typical complication of the procedure with incidence rates reported at between 1 and 22%. The aim of this study was to identify factors that lead to a higher risk of IAN impairment after surgery. MethodA total of 515 surgical wisdom tooth removals having 3D imaging prior to surgical removal were retrospectively evaluated for IAN impairment, along with 3D imaging signs that were supposed predictors for postoperative IAN disturbance. Influence of each predictor was evaluated in univariate and multivariate analyses and reported as odds ratio (OR) with 95% confidence interval (CI). ResultsThe overall IAN impairment rate seen in this study was 9.4%. The low IAN impairment rate seen in this study -when compared to similar selected study groups in the literature of the pre-3D-imaging era -is indicating that the availability of 3D information is actually reducing the risk for IAN impairment after lower third molar removal.