International Journal of Oral & Maxillofacial Surgery
Volume 39, Issue 4 , Pages 320-326 , April 2010

Incidence of neurosensory deficits and recovery after lower third molar surgery: a prospective clinical study of 4338 cases

  • L.K. Cheung

      Affiliations

    • Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong
    • Corresponding Author InformationAddress: Lim K. Cheung, Oral & Maxillofacial Surgery, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong. Tel: +852 28590267; Fax: +852 28575570.
  • ,
  • Y.Y. Leung

      Affiliations

    • Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong
  • ,
  • L.K. Chow

      Affiliations

    • Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong
  • ,
  • M.C.M. Wong

      Affiliations

    • Discipline of Dental Public Health, Faculty of Dentistry, the University of Hong Kong, Hong Kong
  • ,
  • E.K.K. Chan

      Affiliations

    • Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong
  • ,
  • Y.H. Fok

      Affiliations

    • Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong

,Accepted 18 November 2009.

References 

  1. Absi EG, Shepherd JP. A comparison of morbidity following the removal of lower third molars by the lingual split and surgical bur methods. Int J Oral Maxillofac Surg. 1993;22:149–153
  2. Alling CC. Dysesthesia of the lingual and inferior alveolar nerves following third molar surgery. J Oral Maxillofac Surg. 1986;44:454–457
  3. Appiah-Anane S, Appiah-Anane MG. Protection of the lingual nerve during operations on the mandibular third molar: a simple method. Br J Oral Maxillofac Surg. 1997;35:170–172
  4. Bataineh AB. Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg. 2001;59:1012–1017
  5. Bell CW. Use of dental panoramic tomographs to predict the relation between mandibular third molar teeth and the inferior alveolar nerve. Radiological and surgical findings, and clinical outcome. Br J Oral Maxillofac Surg. 2004;42:21–27
  6. Benediktsdottir IS, Wenzel A, Petersen JK, Hintze H. Mandibular third molar removal: risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:438–446
  7. Berge TI, Bøe OE. Predictor evaluation of postoperative morbidity after surgical removal of mandibular third molars. Acta Odontol Scand. 1994;52:162–169
  8. Black CG. Sensory impairment following lower third molar surgery: a prospective study in New Zealand. N Z Dent J. 1997;93:68–71
  9. Blackburn CW, Bramley PA. Lingual nerve damage associated with the removal of lower third molars. Br Dent J. 1989;167:103–107
  10. Blondeau F. Paresthesia: incidence following the extraction of 455 mandibular impacted third molars. J Can Dent Assoc. 1994;60:991–994
  11. Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc. 2007;73:325
  12. Brann CR, Brickley MR, Shepherd JP. Factors influencing nerve damage during lower third molar surgery. Br Dent J. 1999;186:514–516
  13. Bruce RA, Frederickson GC, Small GS. Age of patients and morbidity associated with mandibular third molar surgery. J Am Dent Assoc. 1980;101:240–245
  14. Carmichael FA, McGowan DA. Incidence of nerve damage following third molar removal: a West of Scotland Oral Surgery Research Group study. Br J Oral Maxillofac Surg. 1992;30:78–82
  15. Chiapasco M, De Cicco L, Marrone G. Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 1993;76:412–420
  16. Chossegros C, Guyot L, Cheynet F, Belloni D, Blanc JL. Is lingual nerve protection necessary for lower third molar germectomy? A prospective study of 300 procedures. Int J Oral Maxillofac Surg. 2002;31:620–624
  17. Fielding AF, Rachiele DP, Frazier G. Lingual nerve paresthesia following third molar surgery: a retrospective clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84:345–348
  18. Gargallo-Albiol J, Buenechea-Imaz R, Gay-Escoda C. Lingual nerve protection during surgical removal of lower third molars. a prospective randomised study. Int J Oral Maxillofac Surg. 2000;29:268–271
  19. Goldberg MH, Nemarich AN, Marco WP. Complications after mandibular third molar surgery: a statistical analysis of 500 consecutive procedures in private practice. J Am Dent Assoc. 1985;111:277–279
  20. Gomes AC, Vasconcelos BC, de Oliveira e Silva ED, da Silva LC. Lingual nerve damage after mandibular third molar surgery: a randomized clinical trial. J Oral Maxillofac Surg. 2005;63:1443–1446
  21. Greenwood M, Langton SG, Rood JP. A comparison of broad and narrow retractors for lingual nerve protection during lower third molar surgery. Br J Oral Maxillofac Surg. 1994;32:114–117
  22. Gulicher D, Gerlach KL. Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars. Int J Oral Maxillofac Surg. 2001;30:306–312
  23. Hillerup S. Iatrogenic injury to the inferior alveolar nerve: etiology, signs and symptoms, and observations on recovery. Int J Oral Maxillofac Surg. 2008;37:704–709
  24. Hillerup S, Stoltze K. Lingual nerve injury in third molar surgery I. Observations on recovery of sensation with spontaneous healing. Int J Oral Maxillofac Surg. 2007;36:884–889
  25. Hochwald DA, Davis WH, Martinoff J. Modified distolingual splitting technique for removal of impacted mandibular third molars: incidence of postoperative sequelae. Oral Surg Oral Med Oral Pathol. 1983;56:9–11
  26. Howe G, Poyton HG. Prevention of damage to the inferior dental nerve during the extraction of mandibular third molars. Br Dent J. 1960;355–363
  27. Jerjes W, Swinson B, Moles DR, El-Maaytah M, Banu B, Upile T, et al. Permanent sensory nerve impairment following third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:e1–7
  28. Kipp DP, Goldstein BH, Weiss WW. Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1,377 surgical procedures. J Am Dent Assoc. 1980;100:185–192
  29. Lopes V, Mumenya R, Feinmann C, Harris M. Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg. 1995;33:33–35
  30. Mason DA. Lingual nerve damage following lower third molar surgery. Int J Oral Maxillofac Surg. 1988;17:290–294
  31. Middlehurst RJ, Barker GR, Rood JP. Postoperative morbidity with mandibular third molar surgery: a comparison of two techniques. J Oral Maxillofac Surg. 1988;46:474–476
  32. Miura K, Kino K, Shibuya T, Hirata Y, Shibuya T, Sasaki E, et al. Nerve paralysis after third molar extraction. Kokubyo Gakkai Zasshi. 1998;65:1–5
  33. Obiechina AE. Paraesthesia after mandibular third molar extractions in Nigerians. Odontostomatol Trop. 1990;13:113–114
  34. Pichler JW, Beirne OR. Lingual flap retraction and prevention of lingual nerve damage associated with third molar surgery: a systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;91:395–401
  35. Pogrel MA, Goldman KE. Lingual flap retraction for third molar removal. J Oral Maxillofac Surg. 2004;62:1125–1130
  36. Queral-Godoy E, Figueiredo R, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Frequency and evolution of lingual nerve lesions following lower third molar extraction. J Oral Maxillofac Surg. 2006;64:402–407
  37. Queral-Godoy E, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Incidence and evolution of inferior alveolar nerve lesions following lower third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99:259–264
  38. Rehman K, Webster K, Dover MS. Links between anaesthetic modality and nerve damage during lower third molar surgery. Br Dent J. 2002;193:43–45
  39. Renton T, McGurk M. Evaluation of factors predictive of lingual nerve injury in third molar surgery. Br J Oral Maxillofac Surg. 2001;39:423–428
  40. Robinson PP, Loescher AR, Smith KG. The effect of surgical technique on lingual nerve damage during lower 3rd molar removal by dental students. Eur J Dent Educ. 1999;3:52–55
  41. Robinson PP, Smith KG. Lingual nerve damage during lower third molar removal: a comparison of two surgical methods. Br Dent J. 1996;180:456–461
  42. Rood JP. Lingual split technique. Damage to inferior alveolar and lingual nerves during removal of impacted mandibular third molars. Br Dent J. 1983;154:402–403
  43. Rood JP. Permanent damage to inferior alveolar and lingual nerves during the removal of impacted mandibular third molars. Comparison of two methods of bone removal. Br Dent J. 1992;172:108–110
  44. Rud J. The split-bone technique for removal of impacted mandibular third molars. J Oral Surg. 1970;28:416–421
  45. Rud J. Reevaluation of the lingual split-bone technique for removal of impacted mandibular third molars. J Oral Maxillofac Surg. 1984;42:114–117
  46. Schultze-Mosgau S, Reich RH. Assessment of inferior alveolar and lingual nerve disturbances after dentoalveolar surgery, and of recovery of sensitivity. Int J Oral Maxillofac Surg. 1993;22:214–217
  47. Sisk AL, Hammer WB, Shelton DW, Joy ED. Complications following removal of impacted third molars: the role of the experience of the surgeon. J Oral Maxillofac Surg. 1986;44:855–859
  48. Smith AC, Barry SE, Chiong AY, Hadzakis D, Kha SL, Mok SC, et al. Inferior alveolar nerve damage following removal of mandibular third molar teeth. A prospective study using panoramic radiography. Aust Dent J. 1997;42:149–152
  49. Swanson AE. Incidence of inferior alveolar nerve injury in mandibular third molar surgery. J Can Dent Assoc. 1991;57:327–328
  50. To EW, Chan FF. Lingual nerve retractor. Br J Oral Maxillofac Surg. 1994;32:125–126
  51. Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extractions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:377–383
  52. Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C. C Lingual nerve damage after third lower molar surgical extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:567–573
  53. van Gool AV, Ten Bosch JJ, Boering G. Clinical consequences of complaints and complications after removal of the mandibular third molar. Int J Oral Surg. 1977;6:29–37
  54. Visintini E, Angerame D, Costantinides F, Maglione M. Peripheral neurological damage following lower third molar removal. A preliminary clinical study. Minerva Stomatol. 2007;56:319–326
  55. Walters H. Reducing lingual nerve damage in third molar surgery: a clinical audit of 1350 cases. Br Dent J. 1995;178:140–144
  56. Winter GB. Impacted Mandibular Third Molar. St Louis, MO: American Medical Book; 1926;
  57. Wofford DT, Miller RI. Prospective study of dysesthesia following odontectomy of impacted mandibular third molars. J Oral Maxillofac Surg. 1987;45:15–19

PII: S0901-5027(09)01176-X

doi: 10.1016/j.ijom.2009.11.010

International Journal of Oral & Maxillofacial Surgery
Volume 39, Issue 4 , Pages 320-326 , April 2010