Is lingual nerve protection necessary for lower third molar germectomy? A prospective study of 300 procedures

Chossegros, C.; Guyot, Laurent; Cheynet, F; Belloni, Daniel Teixeira; Blanc, Jean-Luc

doi:10.1054/ijom.2002.0236

Cited by 34 publications

(26 citation statements)

References 20 publications

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“…Surgery on unerupted mandibular third molars was at higher risk (5.8%) of lingual nerve injury compared with erupted (0.3%) or partially erupted (2.0%) teeth (P < 0.0001) [66,73]. The incidence of lingual nerve injury was highest in distally impacted lower wisdom teeth (4.0%, P < 0.01), followed by horizontal impaction (2.8%), mesial impaction (2.4%) and vertical impaction (1.9%) [23,46,66].…”

Section: Resultsmentioning

confidence: 99%

“…It was discussed previously that iatrogenic injury to the lingual nerve may happen during third molar surgery due to the anatomical proximity of the cortex region of the molar to the nerve [52]. Surgery on unerupted mandibular third molars was at higher risk (5.8%) of lingual nerve injury compared with erupted (0.3%) or partially erupted (2.0%) teeth (P < 0.0001) [66,73]. Thus the highest risk of lingual nerve injury was scored in case when the tooth is partially impacted or completely encased in the bone (A2 or A3) and is located closer to the lingual wall.…”

Section: Resultsmentioning

confidence: 99%

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Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification

Juodžbalys

Daugėla

2013

JOMR

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ObjectivesThe purpose of present article was to review impacted mandibular third molar aetiology, clinical anatomy, radiologic examination, surgical treatment and possible complications, as well as to create new mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results.Material and MethodsLiterature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular third molar, impacted mandibular third molar, inferior alveolar nerve injury third molar, lingual nerve injury third molar. The search was restricted to English language articles, published from 1976 to April 2013. Additionally, a manual search in the major anatomy and oral surgery journals and books was performed. The publications there selected by including clinical and human anatomy studies.ResultsIn total 75 literature sources were obtained and reviewed. Impacted mandibular third molar aetiology, clinical anatomy, radiographic examination, surgical extraction of and possible complications, classifications and risk factors were discussed. New mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results was proposed.ConclusionsThe classification proposed here based on anatomical and radiological impacted mandibular third molar features is promising to be a helpful tool for impacted tooth assessment as well as for planning for surgical operation. Further clinical studies should be conducted for new classification validation and reliability evaluation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification

Juodžbalys

Daugėla

2013

JOMR

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“…A 0.6 % to 2.0 % incidence of lingual nerve damage has been reported following third molar extraction. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Lingual nerve damage can result in anaesthesia, par aesthesia, dysaesthesia or hypoaesthesia. Furthermore, depending on the type and severity of nerve disturbance, this dam age can cause drooling, tongue biting, a burning sensation of the tongue, pain and a change in speech pattern.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,[6][7][8][9]19,23 Some attempts to determine the anatomic relationships of the lingual nerve consisted of cadaveric dissections and clinical observations in the third molar region. 2,6,7,11,22 Moreover, the radiographs would have provided useful information for the localisation of the nerve in this area.…”

Section: Discussionmentioning

confidence: 99%

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The relationship of the lingual nerve to the third molar region using radiographic imaging

2007

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PRACTICE I N B R I E F• Lingual nerve damage is a common complication during oral and maxillofacial surgery procedures in the third molar region.• The anatomy of the lingual nerve is variable; therefore precise anatomical knowledge of this nerve is important for decreasing the damage risk.• The data presented in this paper should be a useful reference for surgical procedures undertaken by maxillofacial surgeons.The relationship of the lingual nerve to the third molar region using radiographic imaging P. Karakas, 1 M. Üzel 2 and J. Koebke 3Objective Lingual nerve damage is a common complication during oral and maxillofacial surgery procedures to the third molar region. The anatomy of the lingual nerve is variable, therefore the precise knowledge of anatomy of this nerve is important for decreasing the damage risk. The purpose of this study was to determine the position and the shape of the lingual nerve in the third molar region using radiographic imaging. Setting The Anatomy Department of Cologne Uni versity in Germany. Materials and Methods Firstly, an anatomic dissection of the lingual nerve in the third molar region was done on 10 whole heads and one sagittal hemisection head specimen of adult cadavers. After marking the nerve, x-ray films were taken. Vertical and horizontal measurements were made from the radiographs with an electronic digital caliper. Results The mean vertical and horizontal distances of the nerve to the lingual crista and lingual plate of the mandible were found to be 9.5 ± 5.2 mm and 4.1 ± 1.9 mm respectively. Additionally, of the 21 lingual nerves examined, 17 (81%) were round and 4 (19%) were fl at. Conclusions The results reflect the relationship of the nerve to this area and may help the clinician to avoid the damage risk.

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Surgical techniques for the removal of mandibular wisdom teeth

Coulthard

Bailey

Esposito

et al. 2014

Cochrane Database of Systematic Reviews

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The thirty-five included trials looked at a range of different surgical techniques. The comparisons related to seven broad aspects of the surgical procedures for impacted mandibular third molars: type of surgical flap raised, use of retractors, techniques for bone removal, wound irrigation, wound closure, wound drainage, and complete/incomplete tooth removal. The quality of the body of evidence for each of these comparisons was very low to moderate due to the small number of trials and patients, and the majority of the trials being at high risk of bias (65%) with the remainder at unclear risk of bias.The evidence for making changes to surgical practice is therefore limited. However, it is useful to describe the state of the research evidence supporting practice so that surgeons can make an informed choice in adopting new techniques, or continuing with established techniques.

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Is lingual nerve protection necessary for lower third molar germectomy? A prospective study of 300 procedures

Cited by 34 publications

References 20 publications

Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification

Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification

The relationship of the lingual nerve to the third molar region using radiographic imaging

Surgical techniques for the removal of mandibular wisdom teeth

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