Permanent lingual nerve injury after dental procedures: a retrospective study of 228 patients

• Published in: International journal of oral and maxillofacial surgery 2024-10, Vol.53 (10), p.860-866
• Main Authors: Møller-Hansen, D.P., Baad-Hansen, L., Jensen, S.S.
• Format: Article
• Language: English
• Subjects: Lingual nerve injuries; Neuralgia; Paraesthesia; Retrospective studies; Third molar
• ISSN: 0901-5027; 1399-0020; 1399-0020
• DOI: 10.1016/j.ijom.2024.05.007

Lingual nerve injury (LNI) is a rare, serious complication and previous studies include limited numbers of cases. The aim of this retrospective study was to report the neurosensory outcomes for a large patient cohort with permanent LNI and correlate the mechanism of injury (surgical vs non-surgical) to neurosensory characteristics. Demographics, procedural parameters, mandibular third molar (M3) position, surgeon type, neurosensory test results, and symptoms were recorded for 228 patients and analysed. The majority were female (67.1%). Overall, 59.6% of LNIs were caused by M3 removal and 36.4% by local anaesthesia. Complete loss occurred more frequently in surgical LNIs (P = 0.013). The presence of pain did not differ significantly, however the burning type of pain was significantly more frequent in non-surgical LNIs (P = 0.008) along with altered gustation (P = 0.025). The most common M3 position related to LNI was distoangular (40.4%), class III (63.2%), level A (58.1%) (Winter/Pell and Gregory classifications). The majority of patients undergoing M3 removal were >24 years. A total of 71.7% showed no sign of recovery and 5.5% reported further impairment in their condition. Overall, nine patients underwent microsurgical repair. This study presents neurosensory characteristics potentially decisive for timely referral of operable LNIs.