Lingual nerve injury following surgical removal of mandibular third molar


  • Abduljaleel Azad Samad Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.



Impacted lower third molar, Lingual nerve paraesthesia


Background and objective: The close proximity of lingual nerve in relation to the lingual cortical bone of the posterior mandibular third molar is clinically important because lingual nerve may be subjected to trauma during surgical removal of the impacted lower third molar. This prospective study aimed to evaluate the incidence of lingual nerve paresthesia following surgical removal of mandibular third molar in College of Dentistry, Hawler Medical University.

Methods: A total of 116 third molars surgery were carried out under local anesthesia for 116 patients for removal of lower mandibular teeth Using Terence Ward's incision made in all cases, and after that, the buccal flap was reflected, lingual tissues had been retracted during bone removal with a periosteal elevator. The sensory disturbance was evaluated on the 7th postoperative day by standard questioning the patients: “Do you have any unusual feeling in your tongue, lingual gingiva and mucosa of the floor of the mouth?"

Results: One patient experienced sensory disturbance, the lingual nerve paresthesia incidence was 0.9% as a transient sensory disturbance, while no patient of permanent sensory disturbance.

Conclusion: The incidence of injury to the lingual nerve can be minimized by careful clinical evaluation, surgeon’s experience, surgical approach and knowledge about anatomical landmarks during surgical removal of an impacted lower third molar tooth.


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Carmichael FA, McGowan DA. Incidence of nerve damage following third molar removal. Br J Oral Maxillofac Surg 1992; 30:78-82.

Blondeau F, Daniel NG. Extraction of impacted mandibular third molars. J Can Dent Assoc 2007; 73:325-8.

Susarla SM, Blaeser BF, Magalnick D. Third molar surgery and associated complications. Oral Maxillofac Surg Clin N Am 2003; 15:177-86.

Lopes V, Mumenya R, Feinmann C, Harris M. Third molar surgery: an audit of the indications for surgery, post-operative complaints and patient satisfaction. Br J Oral Maxillofac Surg 1995; 33:33-5.

Loescher AR, Smith KG, Robinson PP. Nerve damage and third molar removal. Dent Update 2003; 30:375-82

Gomes AC, Vasconcelos BC, de Oliveira e Silva ED, da Silva LC. Lingual nerve damage after mandibular third molar surgery: a randomized clinical trial. J Oral Maxillofac Surg 2005; 63:1443-6.

Robinson PP. Textbook and colour Atlas of tooth impaction. 1st ed. Laskin DM: Munksgaard, Copenhagen; 1997.

Blackburn CW, Bramley PA. Lingual nerve damage associated with the removal of lower third molars. Br Dent J 1989; 167:103-7.

Bataineh AB. Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 2001; 59:1012-7.

McGurk M, Haskell R. Wisdom tooth removal and lingual nerve damage. Br J Oral Maxillofac Surg 1998; 37:253-4.

Benediktsdottir IS, Wenzel A, Petersen JK, Hintz H. Mandibular third molar removal risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Path Oral Radiol Endod 2004; 97:438-46.

Harn SD, Durham TM. Incidence of lingual nerve trauma and postinjection complications in conventional mandibular block anaesthesia. J Am Dent Assoc 1990: 121:519-23.

Krafft TC, Hickel R. Clinical investigation into the incidence of direct damage to the lingual nerve caused by local anaesthesia. J Craniomaxillofac Surg 1994: 22:294-6.

Haas DA, Lennon D. A 21 year retrospective study of reports of paresthesia following local anaesthetic administration. J Can Dent Assoc 1995: 61:319-30.

Pogrel MA, Thamby S. Permanent nerve involvement resulting from inferior alveolar nerve blocks. J Am Dent Assoc 2004: 131:901-7.

Stacy GC, Hajjar G. Barbed needle and inexplicable paresthesias and trismus after dental regional anaesthesia. Oral Surg 1994: 77:585-8.

Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg 2006; 35:37-43.




How to Cite

Samad, A. A. (2017). Lingual nerve injury following surgical removal of mandibular third molar. Zanco Journal of Medical Sciences (Zanco J Med Sci), 21(3), 1884–1888.



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