Lingual nerve injury following surgical removal of mandibular third molar

Abstract

Background and objective: The close proximity of lingual nerve in relation to the lingual cortical bone of the posterior mandibular third molar is clinically important because lingual nerve may be subjected to trauma during surgical removal of the impacted lower third molar. This prospective study aimed to evaluate the incidence of lingual nerve paresthesia following surgical removal of mandibular third molar in College of Dentistry, Hawler Medical University.Methods: A total of 116 third molars surgery were carried out under local anesthesia for 116 patients for removal of lower mandibular teeth Using Terence Ward's incision made in all cases, and after that, the buccal flap was reflected, lingual tissues had been retracted during bone removal with a periosteal elevator. The sensory disturbance was evaluated on the 7th postoperative day by standard questioning the patients: “Do you have any unusual feeling in your tongue, lingual gingiva and mucosa of the floor of the mouth?"Results: One patient experienced sensory disturbance, the lingual nerve paresthesia incidence was 0.9% as a transient sensory disturbance, while no patient of permanent sensory disturbance.Conclusion: The incidence of injury to the lingual nerve can be minimized by careful clinical evaluation, surgeon’s experience, surgical approach and knowledge about anatomical landmarks during surgical removal of an impacted lower third molar tooth.