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To evaluate postextractive neurological complications after third molar extraction under general anesthesia and to identify correlations between the surgical procedure, the third molar-related pathology, and neurological involvement.The clinical records of 183 patients were analyzed for a total of 408 third molars extracted at the Dental Clinic of Trieste (Italy). Individual effects of clinical data on the presence of paresthesia were evaluated by a logistic regression model.Neurological involvement was observed in 13 patients (6.1%). No permanent inferior alveolar nerve damage was found (0%) and only 1 patient presented a permanent lesion of the ipsilateral lingual nerve (0.3%). Pell and Gregory classification and surgical difficulty were not associated with the incidence or gravity of neurological lesions (P = NS). Among the pathologies associated with third molars, only the variable “abscess” presented a significant correlation with paresthesia (OR 6.86; 95% CI 1.21-38.8; P = .029).The percentage of nerve injuries agrees with the literature data, inclusion class, and surgical technique seem not to influence paresthesia risk. Further studies are necessary to evaluate the role of infectious pathologies as a cofactor in the development of neurological lesions after oral surgery.