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

Abstract

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.

Comparison of Subjective and Objective Assessments of Neurosensory Function after Lingual Nerve Repair

“…Dias et al [4] noted that the horizontal distance of the lingual nerve from the third molar bone crest was 0.57–9.30 mm, and that the nearest distance was 0 mm [4-6]. The vertical distance of the lingual nerve from the third molar bone crest was 2.28–16.8 mm, and the nearest distance was 1.13 mm [7-9]. Another study reported a lingual nerve running onto an alveolar crest and warned of the possibility of damage to the lingual nerve in third molar extraction [10].…”

Morphology and Morphometry of the Lingual Nerve in Relation to the Mandibular Third Molar

“…[18]. The similarity of the data from studies by Karakas et al [2] and Erdogmus et al [7] which were from same population shows that probably ethnicity has a major influence on the LN dimensions. Previous studies have not correlated LN parameters with the mandibular height.…”

“…Karakas et al [2] reported a mean vertical distance of 9.51 mm which differed from a study by Miloro et al [3] who found a mean of 2.75 mm in which using magnetic resonance imaging to visualize the nerve. Ethnicity may be a major factor leading to this difference since the data were obtained from different populations.…”

Lower Third Molar Region

“…It is a thick nerve whose mean diameter is 2.56 mm (Karakas et al, 2007), and runs the infratemporal region and descends in search of the submandibular hiatus, through which it penetrates the paralingual space where it emits its terminal rami; at the height of the lower second molar, the lingual nerve makes a medial curve to surround the submandibular conduct and emit its terminal rami (Chan et al, 2010a). In its course, the lingual nerve can establish communications with the mylohyoid nerve, which completes its innervation and explains a percentage of aneasthetic failures (Behnia et al, 2000;Kim et al, 2004).…”