Is short-term neurosensory testing after removal of mandibular third molars efficacious?

Abstract

Objective. The purpose of this study was the validation of two-point discrimination, Semmes-Weinstein, and pinprick tests of possible sensory disturbance of the inferior alveolar nerve after the surgical removal of lower wisdom teeth. Study design. Forty-two patients who had undergone elective unilateral lower wisdom tooth removal and 30 control subjects were given two-point discrimination, Semmes-Weinstein, and pinprick tests bilaterally in the dermatome of the mental nerve. Test results were compared to the patients' subjective experiences of sensory disturbance. Statistical analysis was done with multivariate analysis of variance. Results. Untreated sides in patients and test sides in control subjects agreed well for all tests. Five of the 42 patients mentioned sensory disturbance, which was confirmed objectively in 3 (by pinprick and two-point discrimination tests). Testing revealed that 16 of the 42 patients had abnormal pinprick and two-point discrimination tests without subjective sensory disturbance. No abnormal values were found for Semmes-Weinstein tests in any of the patients. Multivariate analysis of variance identified a univariately significant effect of the two-point discrimination test ( p = 0.027); all other interactions were multivariately insignificant. Conclusion. The value of neurosensory testing after third molar removal is limited because of inconsistency between objective test results and subjective findings.