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Review
. 2025 Jul 23;17(7):e88631.
doi: 10.7759/cureus.88631. eCollection 2025 Jul.

Evolving Paradigms in the Management of Trigeminal Nerve Injuries Post Oral Surgery: A Comprehensive Narrative Review

Saanvi Tank  1 , Amit Patil  1 , Tejal Patil  2 , Minal M Kshirsagar  3 , Aarti S Bedia  4 , Sanpreet S Sachdev  5 , Vyshnavi Mundada  1
Affiliations
Review

Evolving Paradigms in the Management of Trigeminal Nerve Injuries Post Oral Surgery: A Comprehensive Narrative Review

Saanvi Tank et al. Cureus. .

Abstract

Trigeminal nerve injuries are among the most challenging complications encountered in oral and maxillofacial surgery, often resulting in significant sensory and functional deficits. The present narrative review explores the evolving paradigms in the diagnosis and management of these injuries, focusing on conventional microsurgical techniques as well as recent advancements in regenerative therapies. Common causes include surgical trauma, chemical insults, and implant-related complications. Diagnostic modalities such as qualitative and quantitative neurosensory testing, cone-beam computed tomography (CBCT), and magnetic resonance neurography are discussed. Management options range from early microsurgical intervention and nerve grafting to the use of nerve conduits, stem cells, growth factors, and electrical stimulation. Despite these advancements, anatomical complexity, timing of intervention, and individual biological variability pose significant limitations. Emerging technologies, including AI-based imaging, soft tissue-driven planning, and virtual surgical simulation, offer promising prospects for improving patient outcomes. The review emphasizes the need for timely, individualized, and multidisciplinary approaches to optimize functional recovery and quality of life.

Keywords: microsurgical repair; nerve regeneration; neurosensory testing; oral surgery; trigeminal nerve injury.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow diagram indicating the selection process of the article in the present narrative review
PICOS: Population, Intervention, Comparison, Outcomes, and Study. *Databases including PubMed, Scopus, Web of Science, and Google Scholar. **Articles not satisfying PICOS criteria.
Figure 2
Figure 2. Treatment planning for a case of trigeminal neuralgia
RCT: Root canal treatment. Image credits: Saanvi Tank and Sanpreet Singh Sachdev.
Figure 3
Figure 3. Treatment strategies available for trigeminal neuralgia
PGA: Polyglycolic acid; SCs: Stem cells; NGF: Nerve growth factor; BDNF: Brain-derived neurotrophic factor; NSC: Neural stem cell; MSC: Mesenchymal stem cell; iPSC: Induced pluripotent stem cells. Image credits: Saanvi Tank and Sanpreet Singh Sachdev.
See this image and copyright information in PMC

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