Assessment of Nerve Injuries after Surgical Removal of Mandibular Third Molar: A Prospective Study

Although third molar extraction is a routinely carried out procedure in a dental set-up, yet it is feared both by the patient and the dentist due to an invariable set of complications associated with it, especially in the form of nerve injuries. Hence, prior to performing such procedures, it would be wise if the clinician thoroughly evaluates the case for any anticipated complications so that adequate preventive measures can be taken to minimize the traumatic outcomes of the procedure and provide maximum patient care, which would further save the clinician from any sort of litigation. 1. Introduction Impacted teeth can be defined as those teeth whose normal eruption is prevented by adjacent tooth, overlying bone or soft tissue, malpositioning and lack of space in the arch, or other impediments. Impacted mandibular 3rd molar is one of the most common findings which is detected on routine dental checkup. However the patient seeks treatment whenever there is pain, swellings or another discomfort. Although the overall complication rate is low and most complications are minor, third molar removal is so common that the population morbidity of complications may be significant. As such, efforts to limit intraoperative or postoperative complications may have a great impact in terms of enhancing patient outcome. Impacted mandibular third molar teeth are in close proximity to the lingual, inferior alveolar, mylohyoid, and buccal nerves (Figure 2). During surgical removal, each of these nerves is at risk of damage, but the most troublesome complications result from inferior alveolar or lingual nerve injuries. The majority of injuries result in transient sensory disturbance but, in some cases, permanent paraesthesia (abnormal sensation), hypoesthesia (reduced sensation), or, even worse, some form of dysaesthesia (unpleasant abnormal sensation) can occur. These sensory disturbances can be troublesome, causing problems with speech and mastication and may adversely affect the patient’s quality of life. They also constitute as one of the most frequent causes of complaints and litigation [1]. 2. Material and Methods The prospective study data was collected from 147 patients visiting the Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College & Hospital, Nagpur, for surgical extraction of impacted mandibular third molar. In this study, preoperative predictive variables were recorded with data record of name, age, gender, and type of impaction. Postoperative assessment was done after one week at the time of suture removal for