Links between anaesthetic modality and nerve damage during lower third molar surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Outcomes Research

Background:

• Third molar removal is a common surgical procedure.
• Nerve damage, particularly to the lingual and inferior dental nerves, is a known complication.
• Factors influencing nerve injury risk require further investigation.

Purpose of the Study:

• To identify relationships between surgical factors and nerve damage during lower third molar extraction.
• To assess the incidence and persistence of sensory disturbances post-surgery.

Main Methods:

• Prospective longitudinal study involving 391 patients undergoing lower third molar removal.
• Sensory disturbance assessment at one week, and follow-up at one, three, and six months.
• Logistic regression analysis to determine significant risk factors.

Main Results:

• 7.5% of procedures had temporary altered sensation; 0.49% had persistent symptoms at six months.
• Lingual nerve injury occurred in 4.23%, inferior dental nerve (IDN) in 3.25%.
• Use of a lingual retractor was a significant predictor of nerve injury (p=0.003), more so than eruption status (p=0.007).

Conclusions:

• Anesthesia type (local vs. general) did not correlate with nerve damage when surgical difficulty was considered.
• Surgical technique, specifically the use of a lingual retractor, is a key factor in preventing nerve injury during third molar surgery.