Background and Objectives The purpose of this prospective study was to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals whose impacted mandibular third molars are surgically removed under local anesthesia. Materials and Methods The study was based on the data collected prospectively from a random group of 100 patients who underwent surgical removal of bony impacted lower third molar in a dental hospital. Details of the patient, reason for extraction, type of impaction, method of surgery and signs and symptoms of nerve injury are recorded. Neurosensory testing was done to evaluate the LNI at 1 week, 1 months, 3 months and 6 months interval.Comparison was carried out using Chi square test. For all tests a P \ 0.05 was considered significant. Results The incidence of LNI was 4 % and of temporary in nature which recovered well within 6 months postoperatively. The age of the patient above 26 years, lingual flap retraction, depth of impaction (red line C10 mm) and duration of surgery above 30 min were the significant factors for causing LNI. Conclusions The age of the patient, depth of impaction, lingual flap retraction and longer duration of surgery are significant risk factors for LNI during mandibular third molar surgery. Greater care should be taken to avoid the morbidity and patients should be informed well ahead about the probable complications.
Fibro-osseous lesions of the jaws can have certain histologic features in common with central giant cell granuloma (CGCG) including the presence of multinucleated giant cells. The clinical, radiologic and histologic features of these lesions should be carefully evaluated to distinguish between these conditions. Fibro-osseous lesions of the jaws are a heterogenous group of lesions characterized by the replacement of normal bone by fibrovascular tissue containing newly formed mineralized material. Central giant cell lesions are defined as an intraosseus lesion consisting of cellular fibrous tissue containing multiple foci of hemorrhage and aggregation of multinucleated giant cells. These lesions may sometimes lead to a confusion in their diagnosis as many pathologists report them taking into consideration one of the prominent histopathologic feature. These confusions may be because of the small number of cases reported in the literature with uncertain clinical, radiographic and histopathologic features of these lesions. So even surgeons may end up treating these lesions inadequately or patients may need to undergo multiple surgeries. We report such a case of Juvenile ossifying fibroma associated with CGCG and discuss the clinical, imaging, histologic, and treatment aspects of this hybrid lesion.
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