Nerve Damage and Third Molar Removal

From Volume 30, Issue 7, September 2003 | Pages 375-382

Authors

A.R. Loescher

BDS, PhD, FDS RCS, MBChB

Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA

Articles by A.R. Loescher

K.G. Smith

BDS, PhD, FDS RCS

Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA

Articles by K.G. Smith

P. P. Robinson

BDS, PhD, FDS RCS, DSc, FMedSci

Department of Oral and Maxillofacial Surgery, School of Clinical Dentistry, Claremont Crescent, Sheffield S10 2TA

Articles by P. P. Robinson

Abstract

The surgical removal of lower third molars endangers both the lingual and inferior alveolar nerves. Patients sustaining an injury to either of these nerves must be managed correctly, and this requires a diagnosis of the injury type and regular monitoring of the recovery of sensation. Surgical intervention for a damaged inferior alveolar nerve is not usually indicated but may be undertaken: if the nerve is completely divided and the severed ends are misaligned; if a bony fragment has compressed the mandibular canal; or if the patient suffers from persistent neuropathic pain. In contrast, after injury to the lingual nerve, if sensory testing demonstrates no neural recovery within 3–4 months, exploration of the injury site and microsurgical repair of the damaged nerve is indicated.

Article

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