The aim of this study was to identify the relative risk of damage to the inferior dental (ID) and lingual nerves in patients undergoing lower third molar removal.
A single surgeon reviewed 1,000 patients.
Temporary ID neurosensory deficit was highest (11%) when root apices were intimate to the ID nerve and lowest (0.9%) when close or distant from the nerve. Permanent ID neurosensory deficit was 0.4% per tooth but only when intimate to the canal. Bone removal, tooth division, and lingual split technique increase the risk of excessive hemorrhage which appears to be linked to the highest risk of temporary ID neurosensory deficit (20%). Permanent lingual nerve injury was rare (0.06%) and not related to lingual retraction.
Preoperative warning for lower third molar removal can be individually tailored depending on the intimacy of the ID canal to the root apices and the anticipated surgical technique.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Clinical and anatomic observations on the relationship of the lingual nerve to the mandibular third molar region.J Oral Maxillofac Surg. 1984; 42: 565-569
- Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies.Int J Oral Maxillofac Surg. 2011; 40: 1-10
- Dysaesthesia of the lingual and alveolar nerves following third molar surgery.J Oral Maxillofac Surg. 1986; 44: 454-457
- Functional disorders of the mandibular nerve caused by the molars.Z Stomatol. 1986; 83: 521-535
- Prospective study of dysesthesia following odontectomy of impacted mandibular third molars.J Oral Maxillofac Surg. 1987; 45: 15-19
- The radiological prediction of ID nerve injury during third molar surgery.Br J Oral Maxillofac Surg. 1990; 28: 20-25
- A prospective study of complications related to mandibular third molar surgery.J Oral Maxillofac Surg. 1985; 43: 767-769
- Dysaesthesia after mandibular third molar surgery; a retrospective study and analysis of 1377 surgical procedures.J Am Dent Assoc. 1980; 100: 185-192
- Prevention of damage to the inferior dental nerve during the extraction of mandibular third molars.Br Dent J. 1960; 109: 355-363
- Comparative efficacy of spiral computed tomography and orthopantomography in preoperative detection of relation of ID neurovascular bundle to the impacted mandibular third molar.J Oral Maxillofac Surg. 2009; 67: 58-66
- Risk factors associated with injury to the ID and lingual nerves following third molar surgery—revisited.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109: 335-345
- Effect of exposed ID neurovascular bundle during surgical removal of impacted lower third molars.J Oral Maxillofac Surg. 2004; 62: 592-600
- Incidence of neurosensory deficits and recovery after lower third molar surgery: a prospective clinical study of 4438 case.Int J Oral Maxillofac Surg. 2010; 39: 320-326
- Guidance on the extraction of wisdom teeth.National Institute of Clinical Excellence, London2000
- Complications following removal of impacted third molars: the role of the experience of the surgeon.J Oral Maxillofac Surg. 1986; 44: 855-859
- Third molar surgery: an audit of the indications for surgery, post operative complaints and patient satisfaction.Br J Oral Maxillofac Surg. 1995; 33: 33-35
- Lingual flap retraction and prevention of lingual nerve damage associated with third molar surgery: a systematic review of the literature.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 395-401
- A randomised controlled clinical trial to compare the incidence of injury to the ID nerve as a result of coronectomy and removal of mandibular third molars.Br J Oral Maxillofac Surg. 2005; 43: 7-12
- Coronectomy: A technique to protect the inferior alveolar nerve.J Oral Maxillofac Surg. 2004; 62: 1447-1452
- Current clinical practice and parameters of care: the management of patients with third molar teeth.in: September 1997: 7-8
- Summary of: the mesioangular third molar-to extract or not to extract?.Br Dent J. 2009; 206: 586-587
- Distal cervical caries in the mandibular second molar: an indication for the prophylactic removal of the third molar?.Br J Oral Maxillofac Surg. 2005; 44: 42-45
Published online: August 24, 2012
Accepted: March 12, 2012
Received in revised form: February 19, 2012
Received: November 15, 2011
© 2013 Published by Elsevier Inc. All rights reserved.