Lingual, inferior alveolar and mylohyoid nerves sensory impairment following removal of mandibular third molars

ABSTRACT

The objectives of this study were to investigate the incidence of sensory impairment of the lingual, inferior alveolar and mylohyoid nerves following lower third molar removal and to compare the outcome with the results of other studies with the intention of implementing any change in the treatment protocol, if indicated and to predict the need for routine postoperative follow up and it's cost implications. A total of 2456 mandibular third molars were removed from 1275 patients of which 585 were operated under general anaesthesia and 690 received local anaesthesia with or without sedation. Of the 1275 patients, 58 [4.57%] experienced transient sensory impairment affecting single or a combination of the above nerves. Only 15 [1.18%] patients had anaesthetic impairment and the rest 43 [3.42%] patient's injury was paraesthetic in nature. All of these resolved completely during the period of study except one patient who suffered permanent impairment of the lingual nerve functions and this occurred in general anaesthetic group. No permanent sensory impairment was recorded for inferior alveolar and mylohyoid nerves. Surgical criteria and treatment justification with appropriate patient information sheet and the need for follow up is discussed