Increased tendency to temporary nerve damage with lingual retractor use

Abstract

Question: Does use of lingual retractor increase risk of nerve damage in third molar retraction? Objective To review the incidence and recovery of lingual nerve damage after the removal of the third molar by three different techniques.Data sources Medline, Health Star, Current Contents, Allied and Alternative Medicine, Life Sciences, Web of Science, Nursing Allied Health and the Cochrane library, up to May 1999. The index of the Journal of Oral and Maxillofacial Surgery Clinics of North America 1989–1998 was also searched together with the bibliographies of identified studies.Study selection Original cases of lingual nerve damage due to third molar removal with >6 months follow-up and clinically objective sensory testing. Three different surgical methods were evaluated: buccal approach with lingual retraction (BA+), buccal approach without lingual retraction (BA−) and lingual split technique (LS).Results Although 51 studies addressed the issue of lingual nerve damage only eight met the inclusion criteria. All comparisons of temporary nerve injury rates between the three surgical groups were significant (P<0.001). A summary of the results is presented below (Table 1).Conclusion The current literature does not show or support any significant advantage for the use of a lingual flap retractor to protect the lingual nerve during third molar surgery. It does show an increased tendency for temporary injury, however.