Prevalence of iatrogenic trigeminal nerve injuries in routine dental practice in private, public, and educational clinics of Riyadh, Saudi Arabia

Abstract

Background: The trigeminal nerve (V) is a critical nerve in the maxillofacial region relevant to dentistry. The nerve trifurcates into ophthalmic, maxillary, and mandibular nerves . The risk of having trigeminal nerve injuries (TNIs) is relatively high as dentists from various specialties perform trigeminal nerve blocks in routine dental practice. The causes of TNIs can be varied and broadly classified into iatrogenic and non-iatrogenic. The current study aimed to assess the prevalence of TNIs, mainly iatrogenic injuries, in Riyadh, Saudi Arabia, and examine the various dental factors associated with these types of nerve injuries. Methods: A cross-sectional study was carried out through a questionnaire. The questionnaire consisted of two major parts: demographic data and injury assessment and management. The participants were 349 in number and were dentists, interns, and dental students working in private, governmental, and educational sectors. The participants were approached by a simple random sampling technique. The reporting of the iatrogenic cases is mainly outlined. Results: Among the participants, 45.9% were dentists, 35.8% students, and 18.3% were interns. Most cases (93%, N = 44) were presented with neuropathy due to iatrogenic injury. Out of the 93% reported cases, 65.9% were related to extractions, 27.3% were associated with implants and restorative procedures, and 18.2% were related to endodontic procedures. Temporary injuries accounted for 82%, whereas permanent injuries were 18%. The inferior alveolar nerve is affected more often than the lingual nerve. Most of these injuries (70%) were referred to oral and maxillofacial surgeons for follow-up. Conclusion: An appropriate assessment, thorough history, and clinical examination would significantly help prevent TNI cases. Moreover, well documentation and prompt reporting and referral by the clinicians would ensure optimum patient care. Therefore, further studies covering the main Saudi regions other than Riyadh city are advocated to establish preventive and management protocols.