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Permanent sensory nerve impairment following third molar surgery: a prospective study
W Jerjes1, B Swinson, D R Moles
1Department of Oral and Maxillofacial Surgery, Eastman Dental Institute for Oral Healthcare Sciences, London, United Kingdom. waseem_wk1@yahoo.co.uk
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|September 26, 2006
Summary
The experience of the surgeon significantly impacts the risk of permanent nerve damage after mandibular third molar removal. Lower rates of inferior alveolar and lingual nerve paresthesia were observed with increased operator experience.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurology
- Dental Anesthesia
Background:
- Third molar removal is a common surgical procedure.
- Nerve injury, including inferior alveolar nerve (IAN) and lingual nerve (LN) paresthesia, is a known complication.
- Understanding risk factors is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of permanent sensory impairment of the IAN and LN after mandibular third molar extraction.
- To identify factors influencing the prevalence of these nerve injuries.
Main Methods:
- Prospective study of 1,087 patients undergoing mandibular third molar removal under local anesthesia.
- Data collected included patient demographics, tooth position, surgeon grade, nerve proximity, and paresthesia prevalence.
- Follow-up assessments were conducted to determine long-term nerve function.
Main Results:
- Inferior alveolar nerve injury occurred in 4.1% at 1 week, decreasing to 0.7% at 2 years.
- Lingual nerve sensory alteration occurred in 6.5% at 1 week, decreasing to 1.0% at 2 years.
- Higher surgeon experience correlated with lower rates of permanent nerve paresthesia.
Conclusions:
- Operator experience is a significant factor in preventing permanent lingual and inferior alveolar nerve paresthesia.
- Minimizing nerve injury risk requires careful surgical technique and consideration of surgeon expertise.
