Permanent sensory nerve impairment following third molar surgery: a prospective study

Jerjes, Waseem; Swinson, B; Moles, David R; El-Maaytah, Mohammed; Banu, Bilquis; Upile, Tahwinder; Kumar, Mukesh; Khawalde, M. Al; Vourvachis, M.; Hadi, H.; Kumar, S.; Hopper, Colin

doi:10.1016/j.tripleo.2006.01.016

Cited by 95 publications

(80 citation statements)

References 32 publications

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“…Sensory impairment following this surgery is probably the most significant morbidity [2] , but this is largely preventable if the potential risk is anticipated and the surgical procedure adapted accordingly. Despite numerous publications and suggested recommendations, there is no significant decrease in the number of cases of permanent LN involvement [5,7,8,[14][15][16] . The prevalence of postoperative lingual sensory impairment in our study compares favorably with other data from previous studies [6,7,15,17] .…”

Section: Discussionmentioning

confidence: 99%

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Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

Baqain¹,

Karaky²,

Hassoneh³

2009

Med Princ Pract

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Objective: The objective of this study was to estimate the frequency of postoperative lingual nerve (LN) impairment after the surgical removal of mandibular third molars (M3) and to identify potential risk indicators. Subjects and Methods: A prospective cohort study involving 321 subjects who had 443 mandibular M3 surgically extracted at the University Hospital, Amman, Jordan. Predictor variables were categorized as patient-, anatomy- and operation-specific. The outcome variable was the presence or absence of LN impairment. Bivariate and multivariate analyses were performed to identify independent predictors. Results: The prevalence of temporary LN hypoesthesia was 2.5% and all 11 cases resolved within 6 months. Factors that predicted LN injury by univariate analysis were horizontal and mesioangular tooth angulation, bone removal, tooth sectioning, longer operations, lingual flap retraction and bleeding into the socket. In the multivariate logistic regression model, lingual flap retraction (p = 0.002, OR = 26.790) and bleeding into the socket (p = 0.044, OR = 4.918) were the independent predictors. Conclusion: Operative variables were the main predictors of temporary LN damage.

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Section: Discussionmentioning

confidence: 99%

“…rior alveolar nerve, a nerve housed in a bony canal, serious injury to the LN has less opportunity to heal as the LN tends to retract and become trapped within scar tissue, requiring surgical intervention in many instances [7,10] .…”

mentioning

confidence: 99%

Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

Baqain¹,

Karaky²,

Hassoneh³

2009

Med Princ Pract

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“…[3][4][5][6]35 The optimal study design to obtain evidence on the impact of CBCT on patient outcome compared with, for example, PAN imaging is the RCT, in which patients after inclusion in the study are randomized to an experimental (CBCT) or a control (e.g. PAN imaging) group.…”

Section: Level 3-effect On Diagnostic Thinkingmentioning

confidence: 99%

“…the alveolar inferior nerve (IAN), the buccal nerve and the lingual nerve, are seen as the most severe postoperative complications after removal of a mandibular third molar. [3][4][5][6] In a radiographic image of the third molar region, only the course of the IAN may be estimated since the mandibular canal, within which the nerve is situated, is usually visible. The course of the other two essential nerves in the region are not seen in radiographs.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Matzen

Wenzel²

2015

Dentomaxillofacial Radiology

114

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A radiographic examination of mandibular third molars is meant to support the surgeon in establishing a treatment plan. For years panoramic (PAN) imaging has been the first choice method; however, where an overprojection is observed between the third molar and the mandibular canal and when specific signs suggest a close contact between the molar and the canal, CBCT may be indicated. The present review provides an evaluation of the efficacy of CBCT for assessment of mandibular third molars using a six-tiered hierarchical model by Fryback and Thornbury in 1991. Levels 1-3 include studies on low evidence levels mainly regarding the technical capabilities of a radiographic method and the diagnostic accuracy of the related images. Levels 4-6 include studies on a higher level of evidence and assess the diagnostic impact of a radiographic method on the treatment of the patient in addition to the outcome for the patient and society including cost calculations. Only very few high-evidence studies on the efficacy of CBCT for radiographic examination of mandibular third molars exist and, in conclusion, periapical or PAN examination is sufficient in most cases before removal of mandibular third molars. However, CBCT may be suggested when one or more signs for a close contact between the tooth and the canal are present in the two-dimensional image-if it is believed that CBCT will change the treatment or the treatment outcome for the patient. Further research on high-evidence levels is needed. Dentomaxillofacial Radiology (

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“…2 Sensory injury of the IAN is a complication that most of the dentists and oral surgeons would like to prevent; the incidence of IAN injury is 0.4-0.7%. 1,2 The rate of temporary damage to the IAN is between 4% and 8% 1,2 when the procedure is performed by an expert surgeon; 2 the damage is the result of direct trauma to the nerve itself (tearing or damaging the nerve by drills or by pushing the root to the canal) or of later complications such as oedema or haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Are different imaging methods affecting the treatment decision of extractions of mandibular third molars?

Manor¹,

Abir²,

Manor³

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To find the differences between treatment decisions of lower impacted third molars among experts of oral and maxillofacial surgery according to panoramic radiographic and CBCT findings. Methods: A retrospective analysis of 62 panoramic radiographs and CBCT of lower third molars evaluated for treatment decisions by 9 independent experts of oral and maxillofacial surgery. Results: Differences in interpretation of the panoramic radiography were found between surgeons. The absence of radiological signs suspected for risk to the inferior alveolar nerve lead to the decision of extraction according to panoramic radiography without CBCT (p , 0.01). The presence of those signs lead to referral to CBCT by surgeons before treatment but did not change their decision. Conclusions: Treatment decision for surgical treatment of the lower third molar can be accepted without CBCT findings. The use of CBCT is popular before extraction of lower third molars. We found that it has a little effect on the treatment decision of the surgical intervention in comparison to panoramic radiography.

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Permanent sensory nerve impairment following third molar surgery: a prospective study

Cited by 95 publications

References 32 publications

Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

Lingual Nerve Morbidity and Mandibular Third Molar Surgery: A Prospective Study

Efficacy of CBCT for assessment of impacted mandibular third molars: a review – based on a hierarchical model of evidence

Are different imaging methods affecting the treatment decision of extractions of mandibular third molars?

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