Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

Abstract

Background Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

Association of the Inferior Alveolar Nerve Position and Nerve Injury: A Systematic Review and Meta-Analysis

“…In total, 1063 articles were initially included, comprising 1023 from electronic searches and 2 from other resources; 625 records were retained after duplicates were removed. We screened the 625 articles and finally found 40 articles [ 4 , 5 , 6 , 8 , 9 , 11 , 15 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ] for further assessment. We assessed 40 articles [ 4 , 5 , 6 , 8 , 9 , 11 , 15 , 16 , 20 ,…”

“…We screened the 625 articles and finally found 40 articles [ 4 , 5 , 6 , 8 , 9 , 11 , 15 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ] for further assessment. We assessed 40 articles [ 4 , 5 , 6 , 8 , 9 , 11 , 15 , 16 , 20 , 21 , 22 , …”

“…Moreover, 29 articles were excluded from among the 40 articles [ 4 , 5 , 6 , 8 , 9 , 11 , 15 , 16 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ] that were read as full texts for the following reasons: 1. The articles did not mention the number of IAN injures in each group, which we required for our analysis; 2.…”

Profiling thermal pain using quantitative sensory testing in patients with trigeminal nerve injury

“…In accordance with the previous studies, the injured lingual nerve is usually not supported by a bony canal while inferior alveolar nerve runs within the canal. Thus, the recovery of IANI is relatively quick while the recovery of an injured lingual nerve is relatively slower than that for the IAN (Loescher, Smith, & Robinson, 2003; Tojyo et al., 2019). In addition, previous studies revealed that the lingual nerve has fewer fascicles with thicker perineurium than the inferior alveolar nerve (Graff‐Radford & Evans, 2003; Tan, Andrawos, Ghabriel, & Townsend, 2014).…”

Mandibular Third Molar Postoperative Complications – A Brief Review

“…The incidence of lingual nerve injury was found to be highest in females ranging from 30-50 years having distoangular impaction. 15 The use of a dentopanoramic tomography [DPT] or a cone-beam computed tomography [CBCT] is improvised in the preoperative assessment relationship between the inferior dental nerve and mandibular third molar. 15 [ Figure 2-4] Inferior dental nerve injury has been reported to have an incidence 0.41 to 8.1% with temporary damage and incidence Iatrogenic injuries could possibly be due to crushing of tissues while elevating the involved tooth.…”