Surgical extraction of impacted inferior third molars at risk for inferior alveolar nerve injury.
The objective of the study was to prospectively assess the intraoperative findings and the radiographic signs of a study population of patients with impacted third molars at risk of inferior alveolar nerve injury. One hundred thirty-four patients with impacted mandibular third molars at risk for nerve injury were included in the study. Radiographic signs of possible close relationship between the 2 structures and intraoperative exposition or damage of the inferior alveolar nerve were recorded. The follow-up controls comprised clinical examinations and assessment for the sensation of the lower lip and chin. In 24 patients, a real contiguity was encountered between the third molars and nerve. Among these, intraoperative neural exposition was observed in 19 patients. Four patients complained of postoperative temporary hypoesthesia. No deficit of sensibility was found in cases with no exposition of the nerve. The accidental exposition of the inferior alveolar nerve is associated with an increased risk for neural injuries. At panoramic radiograph, the presence of signs of bifid and radiolucent apex, superimposition, and radiolucent root band should be considered at high risk for neural damage.
Division of Maxillofacial Surgery, Head and Neck Department, SanGiovanni Battista Hospital, University of Turin, Turin, Italy.
Cesare
C
Gallesio
Mattia
M
Berrone
Emanuele
E
Ruga
Paolo
P
Boffano
D002680:Chin / Q000294:innervation; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007431:Intraoperative Complications / Q000517:prevention & control; D008046:Lip / Q000294:innervation; D008334:Mandible / Q000000981:diagnostic imaging; D008340:Mandibular Nerve / Q000000981:diagnostic imaging; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000294:innervation / Q000601:surgery*; D006472:Oral Hemorrhage / Q000517:prevention & control; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011446:Prospective Studies; D011862:Radiography, Panoramic; D020127:Recovery of Function / Q000502:physiology; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D019227:Tooth Apex / Q000000981:diagnostic imaging; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods*; D014092:Tooth Root / Q000000981:diagnostic imaging; D020390:Tooth Socket / Q000294:innervation; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000601:surgery*; D061221:Trigeminal Nerve Injuries