2022, Vol. 8 Issue 2, Part I
Neurosensory defects after mandibular third molar surgery: A prospective study
AUTHOR(S): Dr. Samah Bashir, Dr. Mohd Younis Bhat and Dr. Ajaz Ahmad Shah
ABSTRACT:Introduction: The most common surgical procedure performed in the oral cavity is extraction of the mandibular third molar, and it has also some complications which include postoperative neurosensory deficits. The incidence of various neurosensory deficits after lower third molar removal has been reported from studies from various countries. For example, inferior alveolar nerve (IAN) injury, which manifests itself as paresthesia or complete loss of sensation of the lower lip and buccal mucosa on the damaged side, has a reported incidence of 0.26-8.4%
Materials and Methods: This was a prospective clinical study of all lower third molar surgeries performed in the Department of Oral & Maxillofacial Surgery Govt. Dental College & Hospital. A total of 500 Patients were included in the study. Patients were excluded if they presented with conditions that were associated with the lower third molars, such as cysts and tumors, or with any preexisting neurosensory deficit related to the IAN and LN. The following data were recorded in a set of questionnaires. The preoperative data recorded were: sex, age, type of impaction (mesioangular, horizontal, distoangular or vertical), depth of impaction (by measuring the winter’s lines) and state of eruption of the lower third molars.
Incidence of Neurosensory Deficits: 5 extractions (1%) resulted in IAN related neurosensory deficits and 10 (2%) resulted in LN-related neurosensory deficits.
Type and Depth of Impaction: Although the incidence of IAN deficit for each type of impaction ranged from 0.2% for vertical to 0.8% for distoangular. The incidence of LN deficit by type of impaction ranged from 0.4% each for mesioangular and horizontal to 1.6% for distoangular
Raising of Lingual Flap and Lingual Nerve Protection: Of the operations involving a raised lingual flap, 5% (7/140) led to postoperative LN deficits.
Tooth Sectioning: Of the 500 dismpactions, 445 (89%) required tooth sectioning. The incidences of IAN deficit in groups with and without tooth sectioning were 1.12% (5/445) and 0% respectively.
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