Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and Maxillofacial SurgeryInferior alveolar nerve damage after lower third molar surgical extraction: A prospective study of 1117 surgical extractions*
Section snippets
Material and methods
This prospective clinical study was conducted in the Department of Oral Surgery and Implantology and consisted of 1117 consecutive surgical removals of lower third molars, selected over a 10-month period in 946 patients. Surgeons were graduate dentists specializing in Oral Surgery (in their first, second, or third year) or teaching professors. The sample has already been described in a previous publication dealing with lingual nerve damage.4
Results
Seven days after surgery, 15 patients had IAN dysfunction on the operated side (1.3% of the surgical procedures). Two of these patients failed to present at follow-up and could not be contacted. Of the 13 patients at follow-up, 9 recovered completely and 4 had persistent lesions. These 4 patients were followed up for a minimum of 88 weeks. Despite this observation period, nerve function remained impaired, without any improvement in more than 6 months. All permanent impairments consisted, to
Discussion
The incidence of IAN damage after lower third molar extraction ranges from approximately 0.5%7, 8 to approximately 8%9, 10; the usual rate is approximately 5%.2, 3, 7, 11 The incidence of IAN damage after lower third molar extraction in our series is very similar to the 1.3% reported in a clinical study involving a surgical technique very similar to our own.12
Our 0.3% incidence of permanent IAN lesions is very similar to the rate reported by Rood,9, 11 who used the lingual split technique.
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2022, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :On the contrary, Selvi et al.20 considered the number of roots which determined a cortical canal perforation, but this variable was uncorrelated with IAN damage anyway. According to Pippi and Santoro10 and Valmaseda-Castellón et al.11, and differently from many other authors1,4,6, the radiographic discontinuity of the mandibular canal cortex was found not to be associated with an increased risk of nerve damage. Moreover, and contrary to other studies1,21,22, not even an intra-operative IAN exposure was significantly related to nerve injury and cannot therefore be considered a "warning signal" for nerve injury but only a clinical confirmation of tooth/nerve proximity which can be concealed by several conditions such as inclination of the alveolar walls or blood clotting above the nerve10.
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