Lingual nerve neuropathy: more than just third molar surgery and inferior alveolar nerve blocks

Neuropathy of the lingual nerve, when it occurs, often results from third molar surgery, or the provision of inferior alveolar nerve blocks. Investigators have reported that the anatomical location and the unpredictable course of the lingual nerve play important roles in it being affected by these procedures. However, there are many other causes of neuropathy with which most medical and dental practitioners are unfamiliar. This article briefly reviews the course of the lingual nerve, and summarizes the causes and reports of all uncommon aetiologies of neuropathy that can occur along the path of a lingual nerve. The clinical implication and management of lingual nerve neuropathy is discussed. CPD/Clinical Relevance: The reader should appreciate the importance of accurately diagnosing lingual nerve neuropathy as it can manifest from many other dental procedures and non-dental causes, apart from routine mandibular third molar surgery and local anaesthetic injections.

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Lingual nerve retraction increases the risk of temporary lingual nerve damage during mandibular third molar surgery

Evidence-Based Dentistry ◽

10.1038/sj.ebd.6400402 ◽

2006 ◽

Vol 7 (2) ◽

pp. 47-47 ◽

Cited By ~ 6

Author(s):

Jonathan P Shepherd

Keyword(s):

Third Molar ◽

Nerve Damage ◽

Lingual Nerve ◽

Third Molar Surgery ◽

Mandibular Third Molar ◽

Mandibular Third Molar Surgery

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Comparison of Articaine and Lidocaine for Buccal Infiltration After Inferior Alveolar Nerve Block For Intraoperative Pain Control During Impacted Mandibular Third Molar Surgery

Anesthesia Progress ◽

10.2344/anpr-64-02-06 ◽

2017 ◽

Vol 64 (2) ◽

pp. 80-84 ◽

Cited By ~ 8

Author(s):

Geraldo Prisco da Silva-Junior ◽

Liane Maciel de Almeida Souza ◽

Francisco Carlos Groppo

Keyword(s):

Nerve Block ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Third Molar Surgery ◽

Inferior Alveolar Nerve Block ◽

Mandibular Third Molar ◽

Intraoperative Pain ◽

Group 2 ◽

Mandibular Third Molar Surgery ◽

Buccal Infiltration

In order to compare the efficacy of lidocaine and articaine for pain control during third molar surgery, 160 patients presenting bilateral asymptomatic impacted mandibular third molars were selected. They received 1.8 mL of 2% lidocaine with epinephrine 1:100,000 during inferior alveolar nerve block. In group 1 (n = 80), an infiltrative injection of 0.9 mL of 2% lidocaine with epinephrine 1:100,000 was performed in buccal-distal mucosa of the third molar. Group 2 (n = 80) received 0.9 mL of 4% articaine with epinephrine 1:100,000 in the contralateral side. All procedures were performed at the same visit, by a single operator, in a double-blind and parallel design. The duration of each surgery and the moment when the patient expressed pain were noted. Data were analyzed by nonpaired t test and chi-square test (alpha = 5%). Duration of surgery did not differ (p = .83) between Groups 1 (19.8 ± 2.3 minutes) and 2 (19.7 ± 3.0 minutes). Pain was expressed more in group 1 (26.3%) than in group 2 (10%) (odds ratio = 3.2, p = .0138). In both groups, tooth sectioning was the most painful event (p < .0001). No influence of gender (p = .85) or age (p = .96) was observed in pain response. Buccal infiltration of 4% articaine with epinephrine 1:100,000 showed more efficacy than 2% lidocaine with epinephrine 1:100,000 when used in combination with inferior alveolar nerve block in controlling intraoperative pain related to impacted mandibular third molar surgery.

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