Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study

L Ridaura-Ruiz,E Valmaseda-Castellon,L Berini-Aytes,R Figueiredo,C Gay-Escoda

doi:10.4317/medoral.17890

Abstract

Objectives: To determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal. Study Design: Prospective cohort study with intra-subject measures of 16 patients undergoing lower third molar extractions. Sensibility and gustatory functions were evaluated in each subject preoperatively, one week and one month after the extraction, using Semmes-Weinstein monofilaments and 5 different concentrations of NaCl, respectively. Additionally, all patients filled a questionnaire to assess subjective perceptions. Results: Although patients did not perceive any sensibility impairments, a statistically significant decrease was detected when Semmes-Weinstein monofilaments. This alteration was present at one week after the surgical procedure and fully recovered one month after the extraction. There were no variations regarding the gustatory function. Conclusions: Lower third molar removal under local anesthesia may cause light lingual sensibility impairment. Most of these alterations remain undetected to patients. These lingual nerve injuries are present one week after the extraction and recover one month after surgery. The taste seems to remain unaffected after these procedures. Key words:Lingual nerve, third molar, nerve injury, paresthesia, surgical extraction

Highlights

The extraction of lower third molars (3M) is one of the most frequent surgical procedures in Dentistry
The taste impulses initiated in the anterior area of the tongue are transmitted to the medulla oblongata through the gustatory fibers that are first integrated in the lingual nerve (LN), branch of the mandibular division of the trigeminal nerve
It was decided to perform a study with the followings aims: to determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal, using Semmes-Weinstein monofilaments, NaCl solutions and a neurosensory questionnaire

Summary

Introduction

The extraction of lower third molars (3M) is one of the most frequent surgical procedures in Dentistry. The taste impulses initiated in the anterior area of the tongue (lingual V) are transmitted to the medulla oblongata through the gustatory fibers that are first integrated in the lingual nerve (LN), branch of the mandibular division of the trigeminal nerve. In a retrospective study carried out in our department (4) based in 4,995 extractions of 3M the figure was lower than that usually published, probably due to the surgical technique that avoided the retraction of the lingual flap. This complication has been related with anatomic factors (proximity of the lingual nerve to the lingual cortical plate) and with the surgeon’s experience (5). It was decided to perform a study with the followings aims: to determine the incidence, severity and duration of lingual tactile and gustatory function impairments after lower third molar removal, using Semmes-Weinstein monofilaments, NaCl solutions and a neurosensory questionnaire

Objectives

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Conclusion