Elimination of permanent injuries to the inferior alveolar nerve following surgical intervention of the “high risk” third molar

Umar, G.; Obisesan, Olamide; Bryant, Catherine; Rood, J.P.

doi:10.1016/j.bjoms.2012.08.006

Cited by 47 publications

(35 citation statements)

References 8 publications

(17 reference statements)

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“…20,21 Following administration of an inferior dental block injection, the prevalence of temporarily impaired lingual and inferior alveolar nerve function ranges from 0.15-0.54%; 6,22 permanent neuropathy is much less frequent (0.0001-0.01%). 6,23 Inferior alveolar nerve injury occurs in 1 in 14,000 inferior dental nerve block injections and is usually temporary (75%) but can persist and become permanent (at three months).…”

Section: Iatrogenic -Surgicalmentioning

confidence: 99%

An update on the causes, assessment and management of third division sensory trigeminal neuropathies

et al. 2016

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Introduction Sensory neuropathies of the mandibular division of the trigeminal (V3) nerve can be debilitating, causing difficulty with daily function. It has a variety of causes, including iatrogenic injury, usually caused by third molar removal, local anaesthetic administration, implant placement or endodontic treatment. Non-iatrogenic causes include infection, primary or secondary neoplasia and various medical conditions.Objective To review the aetiology, evaluation and management of V3 neuropathy in a retrospective case-series of patients referred to a specialist nerve injury clinic over an eight-year period, particularly focusing on the non-iatrogenic causes of this presentation.Methods A retrospective analysis of the case notes of 372 patients referred to the specialist nerve injury clinic between 2006 and 2014 was carried out to establish the cause of the neuropathy and subsequent management or referral. The assessment protocol of trigeminal neuropathy used in the clinic is also outlined.Results Most patients (89.5%) presented with neuropathy due to iatrogenic injury. Of the non-iatrogenic causes (10.5%), malignancy accounted for a fifth of presentations, and infection almost two-fifths, demonstrating the importance of prompt identification of a cause and management by the clinician, or referral to the appropriate specialty. Other, more rare causes are also presented, including multiple sclerosis, sickle-cell anaemia and Paget's disease, highlighting the importance to the clinician of considering differential diagnoses.Conclusions This case series demonstrates the less frequent, but nevertheless important, non-iatrogenic causes which clinicians should consider when assessing patients with trigeminal neuropathy.

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Section: Iatrogenic -Surgicalmentioning

confidence: 99%

An update on the causes, assessment and management of third division sensory trigeminal neuropathies

et al. 2016

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“…This is highlighted by Umar and colleagues, 11 where 200 teeth demonstrating contact with the IAN on imaging were removed with a 12% incidence of temporary hypoesthesia and no permanent deficits. Opponents argue that there have been no randomized clinical trials demonstrating actual outcome benefit with advanced imaging.…”

Section: Nizam II and Ziccardimentioning

confidence: 93%

“…4 For the experienced surgeon, a traditional extraction may still be attempted with good outcome if the prior stated algorithm is used and no absolute contraindications to extraction exist. 11 The authors often use this approach after advanced imaging with surgery performed in the operating room under general anesthesia to allow potential repair of any witnessed nerve injury at the time of surgery. These cases often demonstrate exposure of the nerve intraoperatively, which can be protected by covering with resorbable gelatin sponge.…”

Section: Surgical Strategies For Avoidance Of Injuriesmentioning

confidence: 99%

Trigeminal Nerve Injuries

Nizam

Ziccardi

2015

Oral and Maxillofacial Surgery Clinics of North America

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“…Umar et al [38] after the intervention of 185 patients and a total of Currently, there are programs that are used to elaborate individualized splints, enabling placement of implants assisted by computer (guided surgery). In this way we would take advantage of the reliability of diagnostic image techniques to place implants in the most desired and advantageous position.…”

Section: Right Radiographic Diagnosismentioning

confidence: 99%

Prevention and Treatment of IAN Injuries: A Literature Review

2014

J Interdiscipl Med Dent Sci

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The inferior alveolar nerve (IAN) is one of the most important structures in dentistry. It is a terminal branch that originates from the mandibular root of the trigeminal nerve. This branch courses through the inner aspect of the mandible and innervates teeth and some muscles as the mylohyoid or digastric ones and the gums or lips by its mental branch.Although the main cause of IAN lesion occurs during third molars extractions, IAN can be injured during implant surgery, especially in cases with an atrophic posterior mandible. It is difficult to sever the nerve due to its large caliber. On the contrary, nerve compression or laceration constitute more common complications.Diverse preventive methods to avoid IAN injury have been reported such as using a precise diagnostic procedure as computerized tomography (CT), guided implant surgery, or placing short implants.We may classify nerve injury effects ranging from a light tingling (dysesthesia) to temporary or permanent loss of sensibility (hypoesthesia) or to increased sensibility. These cases require a careful management as these events may increase the patients' and dental practitioners' anxiety. When the IAN has not been totally interrupted, healing occurs in the next 3 to 6 month even spontaneously.Sometimes we can alleviate patients giving them some painkillers or vitamin complexes to minimize symptoms or to improve healing. The use and utility of this kind of treatment is controversial however we should not underestimate its placebo effects.

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Elimination of permanent injuries to the inferior alveolar nerve following surgical intervention of the “high risk” third molar

Cited by 47 publications

References 8 publications

An update on the causes, assessment and management of third division sensory trigeminal neuropathies

An update on the causes, assessment and management of third division sensory trigeminal neuropathies

Trigeminal Nerve Injuries

Prevention and Treatment of IAN Injuries: A Literature Review

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