Objective
Earlier reports, including a preliminary study within our unit, have shown that the
surgeon's experience is one of the most influential factors in determining the likelihood
of both permanent inferior alveolar nerve (IAN) and lingual nerve (LN) paresthesia,
following third molar surgery. The effect of this and other factors influencing such
prevalence are assessed in this study.
Study design
This prospective study involved 3236 patients who underwent surgical removal of impacted
third molars. Patients' demographics and radiological parameters were recorded along
with the grade of the treating surgeon. The prevalence of inferior alveolar and lingual
nerves paresthesia at 1 month, 6 months, and 18 to 24 months postoperatively were
also traced.
Results
At 1 month postoperatively, the incidence of IAN paresthesia was 1.5% and the LN was
1.8%. These figures decreased over time and 18 to 24 months postoperatively, the incidence
of permanent dysfunction of the IAN was 0.6% and LN was 1.1%. With regard to inferior
alveolar nerve paresthesia, risk factors included the patient's age (26-30 years),
horizontally impacted teeth, close radiographic proximity to the inferior alveolar
canal (IAC), and treatment by trainee surgeons. With regard to the lingual nerve,
risk factors included male patients, distoangular impactions, close radiographic proximity
to the IAC, and treatment by trainee surgeons.
Conclusion
One of the main risk factors of developing permanent sensory dysfunction in the distribution
of these nerves is related to the surgical skills/experience of the operator. Other
factors are associated with the type of impaction and the radiographic proximity of
the tooth to the inferior alveolar nerve. Such long-term complications can affect
the patient's quality of life; the impact on profession, education, and research is
unknown.
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Article info
Publication history
Published online: January 25, 2010
Accepted:
October 7,
2009
Received in revised form:
September 20,
2009
Received:
July 4,
2009
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
