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Peripheral neurological damage following lower third molar removal. A preliminary clinical study
E Visintini1, D Angerame, F Costantinides
1Unit of Oral Surgery, Dentistry and Stomatology Clinic, Department of Biomedicine, University of Trieste, Trieste, Italy.
Minerva Stomatologica
|July 13, 2007
Summary
Lower third molar removal risks neurological damage. A study found tooth angulation and proximity to the nerve canal were not linked to lingual or alveolar nerve damage, suggesting surgical technique is key.
Area of Science:
- Oral and Maxillofacial Surgery
- Neurology
- Dental Anatomy
Background:
- Neurological damage to the lingual and inferior alveolar nerves is a risk during lower third molar extraction.
- Tooth impaction and nerve proximity are known risk factors.
Purpose of the Study:
- To assess the relationship between lower third molar angulation and proximity to the mandibular canal and the incidence of peripheral nerve damage.
- To identify risk factors for neurological complications following lower third molar surgery.
Main Methods:
- Sixty-seven patients undergoing lower wisdom teeth extraction were monitored for one year for nerve damage.
- Patients were grouped based on tooth angulation (in axis vs. angulated) and proximity to the mandibular canal (adjacent vs. bone interposition).
- A standardized surgical technique avoiding lingual flap elevation was used.
Main Results:
- Two temporary lingual nerve damages and three temporary inferior alveolar nerve damages were observed.
- No statistically significant differences in nerve damage were found based on tooth angulation or proximity to the mandibular canal.
- All symptoms resolved within five months.
Conclusions:
- Tooth angulation and radiographic proximity to the mandibular canal do not appear to be significant risk factors for lingual or inferior alveolar nerve damage.
- A conservative surgical approach, specifically avoiding lingual flap elevation, may be crucial in preventing neurological complications during lower third molar extraction.