Lingual Nerve Damage After Mandibular Third Molar Surgery: A Randomized Clinical Trial

Gomes, Ana Cláudia Amorim; Vasconcelos, Belmiro Cavalcanti do Egito; Silva, Emanuel Dias de Oliveira e; Silva, Luiz Carlos Ferreira da

doi:10.1016/j.joms.2005.06.012

Cited by 73 publications

(47 citation statements)

References 14 publications

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“…Significantly higher LNI occurred in cases where lingual flap was retracted in the present study. Several studies have shown that raising and retraction of a lingual mucoperiosteal flap is associated with an increased frequency of lingual nerve damage [10,[21][22][23][24]. Few recent studies and a systematic review have concluded that retraction of lingual periosteal flap is not necessary and can be avoided during third molar surgery [25,26].…”

Section: Discussionmentioning

confidence: 99%

“…The procedure was recorded in detail along with the type of impaction, type of intervention and time taken. Patients were then recalled 1 week after the surgery and evaluated for neurosensory deficit (NSD) by both subjective and objective methods [8,10,14].…”

Section: Methodsmentioning

confidence: 99%

“…Objective evaluation was done using mechanoceptive tests which include two-point discrimination test (TPDT), static light touch test (SLTT) and brush directional stroke test (BDST) and nociceptive test like Pinprick test (PPT) [8,10,11,14]. During the test the patient was seated in a quiet room comfortably.…”

Section: Methodsmentioning

confidence: 99%

“…Lingual nerve being main sensory nerve of tongue and tongue coordinating speech, mastication, swallowing, taste sensation, any disturbance in lingual sensation can affect patient functionally as well as psychologically. The reported incidence of sensory disturbance to lingual nerve during third molar removal is 0.2-23 % [8,10,11]. Most often sensory disturbances due to nerve injury undergo spontaneous regeneration and sensory recovery.…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Babu

Reddy²,

Pattathan

et al. 2012

J. Maxillofac. Oral Surg.

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Background and Objectives The purpose of this prospective study was to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals whose impacted mandibular third molars are surgically removed under local anesthesia. Materials and Methods The study was based on the data collected prospectively from a random group of 100 patients who underwent surgical removal of bony impacted lower third molar in a dental hospital. Details of the patient, reason for extraction, type of impaction, method of surgery and signs and symptoms of nerve injury are recorded. Neurosensory testing was done to evaluate the LNI at 1 week, 1 months, 3 months and 6 months interval.Comparison was carried out using Chi square test. For all tests a P \ 0.05 was considered significant. Results The incidence of LNI was 4 % and of temporary in nature which recovered well within 6 months postoperatively. The age of the patient above 26 years, lingual flap retraction, depth of impaction (red line C10 mm) and duration of surgery above 30 min were the significant factors for causing LNI. Conclusions The age of the patient, depth of impaction, lingual flap retraction and longer duration of surgery are significant risk factors for LNI during mandibular third molar surgery. Greater care should be taken to avoid the morbidity and patients should be informed well ahead about the probable complications.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Babu

Reddy²,

Pattathan

et al. 2012

J. Maxillofac. Oral Surg.

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“…This type of lesion may be caused by heavy bruising, compression of the nerve, or even an excessive stretching, manifesting itself in a complete sensory motor paralysis. Functional nerve repair begins from two to six weeks after surgery 9,14 . Nerve regeneration takes place from the point where the damage was caused, so that the axons proliferate towards the effector organ 15 , taking as their guide the Hanken-Bunger bands, composed of Schwann cells.…”

Section: Introductionmentioning

confidence: 99%

Histopathological analysis of gangliosides use in peripheral nerve regeneration after axonotmesis in rats

et al. 2008

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Purpose:To analyze the action of gangliosides in peripheral nerve regeneration in the sciatic nerve of the rat. Methods: The sample was composed of 96 male Wistar rats. The animals were anaesthetized and, after identification of the anaesthesic plane, an incision was made in the posterior region of the thigh, followed by skin and muscle divulsion. The right sciatic nerve was isolated and compressed for 2 minutes. Continuous suture of the skin was performed. The animals were randomly divided into two groups: the experimental group (EG), which received subcutaneous injection of gangliosides, and the control group (CG), which received saline solution (0.9%) to mimic the effects of drug administration. Results: No differences were observed between the experimental and control groups evaluated on the eighth day of observation. At 15 and 30 days the EG showed an decrease in Schwann cell activity and an apparent improvement in fibre organization; at 60 days, there was a slight presence of Schwann cells in the endoneural space and the fibres were organized, indicating nerve regeneration. At 15 and 30 days, the level of cell reaction in the CG had diminished, but there were many cells with cytoplasm in activity and in mitosis; at 60 days, hyperplastic Schwann cells and mitotic activity were again observed, as well as nerve regeneration, but to a lesser extent than in the EG. Conclusion: The administration of exogenous gangliosides seems to improve nerve regeneration. Key words: Gangliosides. Nerve Regeneration. Sciatic Nerve. Rats. RESUMOObjetivo: Avaliar os efeitos de gangliosídeos na regeneração nervosa periférica em nervo isquiático de ratos após axonotmese. Métodos: Foram utilizados 96 ratos machos albinos (Wistar). Os animais foram anestesiados e após constatação do plano anestésico, foi realizada incisão na face posterior da coxa direita do animal. Em seguida, foi realizada a dissecção cirúrgica da pele e do músculo e divulsão dos músculos. O nervo isquiático direito foi isolado e sofreu compressão por 2 minutos. Efetuou-se a sutura contínua da pele. Os animais foram distribuídos aleatoriamente em 2 grupos: experimental (GE) que receberam gangliosídeos pela via sub-cutânea e controle (GC) que receberam soro fisiológico 0,9% com a finalidade de mimetizar os efeitos de administração da droga de estudo. A análise histopatológica foi realizada em 8, 15, 30 e 60 dias. Resultados: Não se evidenciaram diferenças significantes entre os grupos controle e experimental avaliados com 8 dias. Nos grupos experimentais de 15 e 30 dias observouse uma diminuição da atividade das células de Schwann e aparente melhora na organização das fibras nervosas; com 60 dias havia discreta presença células de Schwann no espaço endoneural e as fibras nervosas estavam organizadas sinalizando a regeneração nervosa. Nos grupos controles de 15 e 30 dias o padrão de reação celular diminuiu, entretanto havia muitas células com citoplasmas em atividade e mistose; com 60 dias observou-se ainda a presença de hiperplasia de células de Schwann, a...

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Surgical techniques for the removal of mandibular wisdom teeth

Coulthard

Bailey

Esposito

et al. 2014

Cochrane Database of Systematic Reviews

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The thirty-five included trials looked at a range of different surgical techniques. The comparisons related to seven broad aspects of the surgical procedures for impacted mandibular third molars: type of surgical flap raised, use of retractors, techniques for bone removal, wound irrigation, wound closure, wound drainage, and complete/incomplete tooth removal. The quality of the body of evidence for each of these comparisons was very low to moderate due to the small number of trials and patients, and the majority of the trials being at high risk of bias (65%) with the remainder at unclear risk of bias.The evidence for making changes to surgical practice is therefore limited. However, it is useful to describe the state of the research evidence supporting practice so that surgeons can make an informed choice in adopting new techniques, or continuing with established techniques.

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Lingual Nerve Damage After Mandibular Third Molar Surgery: A Randomized Clinical Trial

Cited by 73 publications

References 14 publications

Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

Histopathological analysis of gangliosides use in peripheral nerve regeneration after axonotmesis in rats

Surgical techniques for the removal of mandibular wisdom teeth

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