scholarly journals Clinical Significance of Intraoperative Exposure of Inferior Alveolar Nerve during Surgical Extraction of the Mandibular Third Molar in Nerve Injury

2021 ◽  
Vol 10 (19) ◽  
pp. 4379
Author(s):  
Sung-Woon On ◽  
Seoung-Won Cho ◽  
Soo-Hwan Byun ◽  
Byoung-Eun Yang

During extraction surgery, the inferior alveolar nerve (IAN) can occasionally be observed in the extraction socket of the mandibular third molar (M3). The purpose of this study was to investigate and compare the incidence of IAN injury in groups with and without intraoperative IAN exposure during surgical extraction of M3, and to identify additional risk factors for the IAN injury in addition to the IAN exposure. A total of 288 cases in 240 patients, who underwent surgical extraction of M3 by a single surgeon, were divided into the exposed group (n = 69) and the unexposed group (n = 219). The surgeon recorded the information regarding the procedure when the clinical observation of IAN exposure was made during the surgery. The incidence of IAN injury after the extraction surgery was significantly higher in the exposed group than in the unexposed group (4.3% versus 0%, p < 0.05). Paresthesia was recognized in three cases of the exposed group, but it showed complete recovery within three postoperative months. No case of permanent paresthesia was detected in both groups. According to the logistic regression, the only significant risk factor of IAN injury in the exposed group was the increase of age (OR 1.108, p < 0.05). Intraoperative IAN exposure during surgical extraction of M3 may show a higher incidence of IAN injury than the case without IAN exposure, representing an incidence of 4.3%. Even if the paresthesia associated with IAN exposure occurs, it is likely to be a temporary injury, and this risk may increase with age.

2021 ◽  
Vol 11 (2) ◽  
pp. 816
Author(s):  
Hee Jin Kim ◽  
Ye Joon Jo ◽  
Jun Seok Choi ◽  
Hyo Joon Kim ◽  
Jin Kim ◽  
...  

The purpose of this study was to analyze the incidence and risk factors of possible inferior alveolar nerve (IAN) injury after extraction of the mandibular third molars. A total of 6182 patients were examined for 10,310 mandibular third molar teeth. Panoramic radiography and patients’ medical records were used to analyze age, gender, and impaction pattern of the mandibular third molar. Cone beam computed tomography (CBCT) was used to investigate the detailed pathway of the inferior alveolar nerve and evaluated the presence of symptoms of nerve damage after tooth extraction. In CBCT, 6283 cases (61%) of the inferior alveolar nerve were actually in contact with the root of the mandibular third molar. The correlation with the panoramic signs of root darkening (p < 0.001), root deflection (p < 0.001), interruption of the IAN (p < 0.001), diversion of the IAN (p < 0.001), and narrowing of the IAN (p < 0.001) had statistical significance. Of the 4708 patients who underwent surgical extraction, 31 (0.658%) complained of nerve damage. Among them, 30 patients (0.637%) complained of symptoms of inferior alveolar nerve damage, and 1 patient (0.02%) complained of symptoms of lingual nerve damage. There was a significant correlation with IAN injury in cases where the roots became dark at the IAN area (p = 0.018) and there was diversion of the IAN at the root area (p = 0.041). When the narrowing of the IAN and the lingual driving pathway of the inferior alveolar nerve appeared simultaneously in CBCT, the risk of IAN injury was high.


2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.


2016 ◽  
Vol 44 (5) ◽  
pp. 616-621 ◽  
Author(s):  
A.J. Kouwenberg ◽  
L.P.P. Stroy ◽  
E.d.Vree- v.d. Rijt ◽  
G. Mensink ◽  
P.J.J. Gooris

2019 ◽  
Vol 21 (3) ◽  
pp. 224-229
Author(s):  
Rashmi Shakya Gurung ◽  
K. Bimb ◽  
D. Shrestha

Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.


2017 ◽  
Vol 64 (2) ◽  
pp. 80-84 ◽  
Author(s):  
Geraldo Prisco da Silva-Junior ◽  
Liane Maciel de Almeida Souza ◽  
Francisco Carlos Groppo

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 &lt; .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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