Lingual Nerve Damage during 3rd Molar Surgery

A prospective study was carried out on seven hundred and seventy five surgically removed third molars and the effects of operators, assistants, lingual flap elevation, bone removal, sectioning of tooth, the instruments used (bur, chisel and osteotome) and suturing were studied. All the procedures were done under general anaesthesia. The data was tested statistically by applying the chi-squared test. The incidence of lingual nerve damage was determined as 5 %. The most strongly implicated causative factors were, elevation of lingual flap, tooth sectioning, bone removal and use of burs, chisels and osteotomes. Suturing and the assistant's identity & seniority were also significant. Given the level of seniority of operators there was individual variations. It was not significant. The study suggests that though the incidence of lingual nerve damage is lower than shown by other researchers the danger of lingual nerve damage exists as a significant risk in the third molar surgery. The surgeon should be aware of this risk and the patient should be told of it before the consent is signed.