Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies

doi:10.1016/j.ijom.2010.09.005

International Journal of Oral and Maxillofacial Surgery

Volume 40, Issue 1, January 2011, Pages 1-10

https://doi.org/10.1016/j.ijom.2010.09.005 Get rights and content

Abstract

This literature review assessed the risk factors linked to inferior dental nerve (IDN) and lingual nerve (LN) deficits following lower wisdom tooth surgery. A computer search of several databases with specified key words was performed. 32 articles were selected; the risk factors for IDN deficit were reported in 4 articles, LN in 9 and both IDN and LN in 19. Data were analysed statistically to evaluate the potential risk factors. Literature review showed specific radiographic signs and intra-operative IDN exposure increased the risk of IDN deficit. Raising the lingual flap significantly increased the risk of LN deficit. Unerupted tooth and lingual split technique increased IDN and LN deficit risks significantly. Age was linked to IDN and LN deficits, and deep impaction was related to IDN deficit, but no statistical tests were performed on these two risk factors owing to the heterogeneity of data from the studies. This literature review found increased age, unerupted tooth, deep impaction, specific radiographic signs, intra-operative IDN exposure and lingual split technique were risk factors for IDN deficit; increased age, unerupted tooth, distal impaction, raising of lingual flap and lingual split technique were risks factors for LN deficit in lower wisdom tooth surgery.

Section snippets

Materials and methods

Computer databases, including PubMed, Ovid and the Cochrane Library, were searched from the earliest available date to 8 June 2007. No language restrictions were applied. The electronic search was performed using the keywords: 1, third molar; 2, wisdom tooth; 3, inferior alveolar nerve; 4, inferior dental nerve; 5, lingual nerve; 6, trigeminal nerve; 7, nerve damage; 8, sensory disturbance; 9, sensory deficit; 10, sensory impairment; 11, nerve injury; 12, (1 OR 2) AND (3 OR 4 OR 5 OR 6 OR 7 OR

Results

367 potential articles were found in Pubmed, an extra 20 articles in Ovid and an additional 11 articles in the Cochrane Library. The abstracts of these articles were screened and 112 articles were considered to be relevant to wisdom tooth surgery and neurosensory deficit, and were channeled into the second round search and evaluation.

12 articles were selected from the reference search of the 112 articles entering the first round. One submitted article from the authors’ centre was also included²⁴

Discussion

The risk factors for IDN deficit in lower wisdom tooth surgery were found to be increasing age, unerupted tooth, deep impaction, specific radiographic signs, intra-operative IDN exposure and using the lingual split technique. The risk factors for LN deficit in lower wisdom tooth surgery were increasing age, unerupted tooth, distal impaction, raising of lingual flap and using the lingual split technique.

The mean age of the patients with postoperative LN or IDN deficit was greater than for those

Funding

None.

Conflict of interest

None.

Ethical approval

Not required.

Acknowledgements

The authors would like to thank Dr Wing Kit Li and Dr Ivan Tsui for participating in this research as independent judges in the article selection process, and Dr Mei Chong for her contributions to this research.

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Invited Review PaperOral SurgeryRisk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies

Abstract

Section snippets

Materials and methods

Results

Discussion

Funding

Conflict of interest

Ethical approval

Acknowledgements

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J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

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Int J Oral Maxillofac Surg

J Oral Maxillofac Surg

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Pain

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Oral Surg Oral Med Oral Pathol

Int J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

J Am Dent Assoc

J Oral Maxillofac Surg

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

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Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Am Dent Assoc

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Oral Maxillofac Surg

J Oral Maxillofac Surg

J Am Dent Assoc

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

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Invited Review Paper
Oral Surgery
Risk factors of neurosensory deficits in lower third molar surgery: a literature review of prospective studies