A Standardized Step-by-step Technique to Protect Lingual Flap During Third Molar Surgery Avoiding Lingual Nerve Injury: a Retrospective Analysis

Abstract

Abstract Purpose The aim of this study was to assess a standardized flap technique use in the surgical extraction of the lower third molar, protecting the lingual flap and avoiding lingual nerve injury. Methods A 5 years retrospective analysis of surgical third molar surgery made by third-year oral surgery specialty program students was made in the department of oral surgery of Clinica Odontoiatrica, Policlinico Umberto I in Roma, from 2017 to 2022. All surgery were carried out using a standardized step by step technique to protect the lingual flap during the surgery. Every patient underwent a review on the initial postoperative day and subsequently, one week after the surgery, coinciding with the removal of the sutures. During each postoperative visit, thorough examinations were conducted to assess any sensory nerve impairment of the inferior alveolar, lingual, or mylohyoid nerves. Results None of the cases reported postsurgical lingual nerve injury; there was zero incidence of lingual nerve paresthesia or dysesthesia. There was no increased risk to the lingual nerve paresthesia or dry socket, which were identified. Conclusions This flap proved to be a standardized and reproducible approach for the surgical removal of lower third molars without raising the risk of lingual nerve sensory impairment, regardless of the operator’s experience.