Frequency of Lingual Nerve Damage during Surgical Removal of Impacted 3rd Molar

Abstract

Introduction: Professional skills, training and experience is mandatory for removing impacted 3rd molars with aid of local/general anesthesia, sedation. As for symptomatic 3rd molars decision for removing is not difficult usually, but for removing asymptomatic 3rd molars decision is less clear & requiring good clinical experience. Objective: The objective this study was to determine frequency of lingual nerve damage during surgical removal of impacted 3rd molar Design: Descriptive cases series Study Setting: This study was conducted at Department of Oral and Maxillofacial Surgery, Sandeman Provincial Hospital Quetta over 6 months (April 10, 2018 till Oct 10, 2018). Materials and Methods: All 149 cases after approval of hospital ethical committee fulfilling the inclusion criteria were included in this study. After clinical and radiographic diagnosis of affected tooth like depth, position or any other difficulty, the surgical procedure was selected. An impacted tooth was labeled when it was failed to explode into the dental arch within the expected developmental window. After operation surgical sites of all patients were reviewed by the same consultant after 7 days. It was instructed to all patients that report any problem in lingual sensation; by clinical examination sensory deficits were recognized bilaterally. Results: The mean age of all cases was 29.82 ± 6.81 years with minimum and maximum age of 18 and 40 years. There were 83(55.7%) male and 66(44.3%) were females. According to types of impaction 22(14.8%) cases had Mesioangular, 10(6.7%) had Horizontal, 12(8.1%) had Vertical, 17(11.4%) had Distoangular, 14(9.4%) had Class I, 15(10.1%) had Class II, 11(7.4%) had Class III, 14(9.4%) had Class A, 16(10.7%) had Class B and 18(12.1%) cases had Class C. A total of 16(10.7%) cases had inguinal injury in this study. Conclusion: This study concludes that 10.7% cases had inguinal injury in this study. So, this procedure of impacted mandibular third molar is associated with minor but expected complications like the lingual nerve damage. Hence, preoperative and intraoperative consideration must be taken up to reduce this preventable complication. Keywords: Impacted teat, 3rd molar, surgery, complications, lingual nerve damage