Inferior Alveolar Nerve Damage after Mandibular Third Molar Surgical Extraction in Dental Patients Visiting 28 Military Dental Centre, Lahore
DOI:
https://doi.org/10.70749/ijbr.v3i7.3014Keywords:
Mandibular Nerve Injury, Molar, Postoperative Complications, Third.Abstract
Objectives: To determine the frequency of inferior alveolar nerve injury after mandibular third molar extraction. Study design: Descriptive case series. Place and Duration of the study: 28 Military Dental Centre, Lahore from December-2024 to May-2025. Methodology: A total of 250 patients were included who required extraction of impacted mandibular third molar tooth located nearby the inferior alveolar nerve with a Pederson scale difficulty index > 4. Patients were assessed on day two, day seven and at three months for damage to the inferior alveolar nerve. Frequency of the nerve damage was stratified by age & gender and post-stratification comparison was performed using Chi-square test. Results: In this study, 250 patients were included. Median age was 31.00 (9.00) years with 118 (47.20%) patients having age 20-30 years and 132 (52.80%) were aged 31-40 years. There were 116 (46.40%) male and 134 (53.60%) female patients. Among patients who underwent surgical extraction of the mandibular third molar, frequency of IAN damage was 12 (4.80%). Conclusion: Frequency of damage to inferior alveolar nerve after extraction of impacted mandibular third molar tooth was 4.80%.
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1. Gay-Escoda, C., Sánchez-Torres, A., Borrás-Ferreres, J., & Valmaseda-Castellón, E. (2022). Third molar surgical difficulty scales: Systematic review and preoperative assessment form. Medicina Oral Patología Oral y Cirugia Bucal, e68-e76.
https://doi.org/10.4317/medoral.2495
2. Pinto, A. C., Francisco, H., Marques, D., Martins, J. N., & Caramês, J. (2024). Worldwide prevalence and demographic predictors of impacted third molars—Systematic review with meta-analysis. Journal of Clinical Medicine, 13(24), 7533.
https://doi.org/10.3390/jcm13247533
3. Ye, Z., Qian, W., Wu, Y., & Yang, C. (2021). Pathologies associated with the mandibular third molar impaction. Science Progress, 104(2).
https://doi.org/10.1177/00368504211013247
4. Venkatachalam, V., & Pandiarajan, R. (2022). Does the impacted mandibular third molar increase the risk of angle fracture to prevent the incidence of condylar fracture? – A retrospective analysis. Annals of Maxillofacial Surgery, 12(2), 185-189.
https://doi.org/10.4103/ams.ams_157_21
5. Jeyashree, T., & Kumar, M. P. (2022). Evaluation of difficulty index of impacted mandibular third molar extractions. Journal of Advanced Pharmaceutical Technology & Research, 13(Suppl 1), S98-S101.
https://doi.org/10.4103/japtr.japtr_362_22
6. Mena Alencastro, S. A., & Rockenbach, M. C. (2023). Complications in the extraction of impacted, and retained third molars. Literature review. [English translation-original in Spanish]. Odontología Vital, 1(38), 26-33.
https://doi.org/10.59334/rov.v1i38.547
7. Blasi, A., Cuozzo, A., Marcacci, R., Isola, G., Iorio-Siciliano, V., & Ramaglia, L. (2023). Post-operative complications and risk predictors related to the avulsion of lower impacted third molars. Medicina, 59(3), 534.
https://doi.org/10.3390/medicina59030534
8. Chai, Y., Dong, Y., Lu, Y., Wei, W., Chen, M., & Yang, C. (2024). Risk factors associated with inferior alveolar nerve injury after extraction of impacted lower mandibular third molars: A prospective cohort study. Journal of Oral and Maxillofacial Surgery, 82(9), 1100-1108.
https://doi.org/10.1016/j.joms.2024.05.003
9. Nguyen, E., Grubor, D., & Chandu, A. (2014). Risk factors for permanent injury of inferior alveolar and lingual nerves during third molar surgery. Journal of Oral and Maxillofacial Surgery, 72(12), 2394-2401.
https://doi.org/10.1016/j.joms.2014.06.451
10. Agbulut, N. (2025). Assessing nerve injuries in oral surgery: A survey-based study on prevention and management. Medicina Oral Patología Oral y Cirugia Bucal, e462-e468.
https://doi.org/10.4317/medoral.26995
11. Pippi, R. (2024). An old technique as an alternative to Coronectomy in lower third molar surgery: Extraction! Journal of Oral and Maxillofacial Surgery, 82(7), 743-745.
https://doi.org/10.1016/j.joms.2024.03.027
12. Orchard, A., Adatia, A., Moore, R., & Prabhu, S. (2022). Management of inferior alveolar nerve and lingual nerve injuries in the UK – a cross-sectional study. British Journal of Oral and Maxillofacial Surgery, 60(7), 927-932.
https://doi.org/10.1016/j.bjoms.2022.01.012
13. Kämmerer, P. W., Heimes, D., Hartmann, A., Kesting, M., Khoury, F., Schiegnitz, E., Thiem, D. G., Wiltfang, J., Al-Nawas, B., & Kämmerer, W. (2024). Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: A comprehensive approach from diagnosis to therapeutic interventions. Clinical Oral Investigations, 28(4).
https://doi.org/10.1007/s00784-024-05615-4
14. Khan, A. A., & Borle, R. (2024). Protocol for diagnostic test accuracy study: Evaluation of cone beam computed tomography (CBCT) in prediction of inferior alveolar nerve injury as compared to Orthopantomography (OPG) secondary to surgical removal of impacted mandibular third molars. Cureus.
https://doi.org/10.7759/cureus.66864
15. Patel, P., Shah, J., Dudhia, B., Butala, P., Jani, Y., & Macwan, R. (2020). Comparison of panoramic radiograph and cone beam computed tomography findings for impacted mandibular third molar root and inferior alveolar nerve canal relation. Indian Journal of Dental Research, 31(1), 91.
https://doi.org/10.4103/ijdr.ijdr_540_18
16. Albayati, M. T., & Bede, S. Y. (2023). Reliability of two difficulty indexes in predicting the surgical extraction difficulty of impacted mandibular third molars. Journal of Oral Medicine and Oral Surgery, 29(1), 5.
https://doi.org/10.1051/mbcb/2023006
17. Ram, G., Ali, A., Khatoon, S., Iqbal, S. N., Sultan, D., & Roma, .. (2024). Comparison of accuracy of WHARFE assessment and Pederson difficulty index for predicting surgical difficulty in patients with impacted mandibular third molar surgery. Pakistan Journal of Health Sciences, 228-232.
https://doi.org/10.54393/pjhs.v5i12.2444
18. Gebeyehu, T., & Abaynew, Y. (2024). Prevalence and patterns of third molar impaction among ethiopians in Addis Ababa: A retrospective pilot study. Scientific Reports, 14(1).
https://doi.org/10.1038/s41598-024-59821-x
19. Al-Madani, S. O., Jaber, M., Prasad, P., & Maslamani, M. J. (2024). The patterns of impacted third molars and their associated pathologies: A retrospective observational study of 704 patients. Journal of Clinical Medicine, 13(2), 330.
https://doi.org/10.3390/jcm13020330
20. Ahmad, P., V'Vian, T., Chaudhary, F., Chaudhary, A., Haseeb, A., Yaqoob, M., & Asif, J. (2021). Pattern of third molar impactions in north-eastern peninsular Malaysia. Nigerian Journal of Clinical Practice, 24(7), 1028-1036.
https://doi.org/10.4103/njcp.njcp_499_20
21. Bakri, M. M., Ali Ali Hezam, A., Ahmad Qurishi, A., Alotaibi, F. I., Sulaiman Aljabri, Y., Sharrahi, H. M., Omar Hablool, M., & Mohammed Arishy, L. (2024). The influence of arch shape on the incidence of third molar impaction: A cross-sectional study. The Saudi Dental Journal, 36(9), 1221-1226.
https://doi.org/10.1016/j.sdentj.2024.07.003
22. Maqbool, S., Khan, N. S., Abbas, I., & Khan, A. (2024). Frequency of Inferior Alveolar Nerve Injury During Third Molar Extraction. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 34(6), 723–726.
https://doi.org/10.29271/jcpsp.2024.06.723
23. Pippi, R., De Luca, S., & Pietrantoni, A. (2022). A prospective observational study on the variables affecting the risk of inferior alveolar nerve damage during lower third molar surgery with nerve/Root proximity. Journal of Oral and Maxillofacial Surgery, 80(1), 13-21.
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