Abstract
Background: The surgical extractions of impacted mandibular third molars are sometimes associated with nerve morbidity. Objective: To determine the incidence of nerve morbidity after mandibular third molar surgery and compare the complications from the inferior alveolar and lingual nerves in two cohorts of patients. Patients and methods: This prospective study was an investigation of two cohorts of patients within duration of four years. The sample size was composed of 212 subjects, made up of 28 patients who had their impacted third molars in close contact with the inferior alveolar canal and 184 patients that did not have their molars in contact. The predictor variables were age, gender, type of impaction, indications for extraction, difficulty index and duration of surgery. The outcome variable was the development of neuro-sensory complication(s) after treatment. Descriptive and bivariate statistics were computed and the P value was set at 0.05. Results: There was no significant relationship between the predictor variables in the two groups. The result showed that 6/212 (2.8%) patients complained of numbness of the ipsilateral lower lip and part of the cheek. Out of this 4/28 (14.3%) were in those that had their molars in close contact with inferior alveolar canal while 2/184 (1.1%) were cases that didn’t make contact. No complication occurred that was related to the lingual nerve. Conclusion: Nerve morbidity occurred after third molar surgery and the incidence is commoner in cases where the third molar made contact with inferior alveolar canal.
Highlights
The surgical extraction of impacted mandibular third molars is a common procedure carried out in the dental surgery, and oral and maxillofacial surgery setting [1,2]
This prospective, single-blinded clinical study was undertaken to determine the incidence of nerve morbidity after mandibular third molar surgery and compared the complications arising from the inferior alveolar and lingual nerves in two cohorts of patients
In group B, the patients’ impacted mandibular third molars were not in close contact with the inferior alveolar canal (n=184, Figure 2).The anatomical relationship between the inferior alveolar nerve and the impacted third molars were judged with oblique lateral radiograph of the affected side as recommended by Rood and Shehab [11] in an attempt to predict the likelihood of nerve damage during surgery
Summary
The surgical extraction of impacted mandibular third molars is a common procedure carried out in the dental surgery, and oral and maxillofacial surgery setting [1,2]. Some impacted mandibular third molar teeth are in close proximity to the lingual, inferior alveolar, mylohyoid and buccal nerves. As the majority of these nerve injuries result in transient sensory disturbance, in some cases, permanent paraesthesia, hypoaesthesia or dysaesthesia can occur requiring appropriate treatment [8,9]. These sensory disturbances can be devastating to the patients because of its effect on speech, swallowing, mastication and social interaction, which may invariably adversely affect the patients’ quality of life [6,7,10]. The surgical extractions of impacted mandibular third molars are sometimes associated with nerve morbidity
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