Sensory nerve impairment following mandibular third molar surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Neurology
• Dental Anesthesia

Background:

• Sensory nerve impairment is a known complication of impacted mandibular third molar extraction.
• Understanding the specific risk factors is crucial for patient safety and surgical technique refinement.

Purpose of the Study:

• To determine the incidence of sensory nerve impairment affecting the inferior alveolar and lingual nerves.
• To identify factors influencing these nerve injuries during impacted mandibular third molar removal under local anesthesia.

Main Methods:

• A prospective study involving 741 patients undergoing mandibular third molar extraction under local anesthesia.
• Data collected included patient demographics, surgical details (tooth angulation, lingual flap use, tooth division), operator experience, and incidence of nerve paresthesia.

Main Results:

• Lingual nerve paresthesia occurred in 2.6% of patients, significantly associated with lingual flap elevation (P <.001).
• Inferior alveolar nerve paresthesia occurred in 3.9% of patients, highest in those under 20 and significantly related to operator experience (P <.001).

Conclusions:

• Lingual flap elevation is a significant risk factor for lingual nerve paresthesia.
• Operator experience is a significant factor in inferior alveolar nerve paresthesia following mandibular third molar surgery.