Sensory nerve impairment following mandibular third molar surgery

Abstract

Purpose: This prospective study reports the rate and factors influencing sensory impairment of the inferior alveolar and lingual nerves after the removal of impacted mandibular third molars under local anesthesia.

Patients and methods: There were 741 patients with 741 mandibular third molars removed under local anesthesia during a 3-year period from 1994 to 1997. Standardized data collection included the patient's name, age and gender, side of operation, angulation of the tooth, lingual flap elevation, use of vertical or horizontal tooth division, the experience of the operator, and the occurrence of lingual and/or inferior alveolar nerve paresthesia.

Results: Postoperative lingual nerve paresthesia occurred in 19 patients (2.6%). There was a highly significant increase in the incidence associated with raising of a lingual flap (P <.001). The incidence of inferior alveolar nerve paresthesia was (3.9%). It was highest in the under 20-year-old age group (9.8%), and there was a highly significant relationship to the experience of the operator (P <.001). Statistical analyses revealed that both lingual and inferior alveolar nerve paresthesia were unrelated to the other variables.

Conclusions: The elevation of lingual flaps and the experience of the operator are significant factors contributing to lingual and inferior alveolar nerve paresthesia, respectively.