J Korean Assoc Oral Maxillofac Surg 2019; 45(5): 233~240
Management and prevention of third molar surgery-related trigeminal nerve injury: time for a rethink
Yiu Yan Leung
Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong
Yiu Yan Leung
Oral and Maxillofacial Surgery, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong TEL: +852-2859-0511 FAX: +852-2857-5570
E-mail: mikeyyleung@hku.hk
ORCID: https://orcid.org/0000-0002-6670-6570
Received September 16, 2019; Accepted September 19, 2019.; Published online October 31, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Trigeminal nerve injury as a consequence of lower third molar surgery is a notorious complication and may affect the patient in long term. Inferior alveolar nerve (IAN) and lingual nerve (LN) injury result in different degree of neurosensory deficit and also other neurological symptoms. The long term effects may include persistent sensory loss, chronic pain and depression. It is crucial to understand the pathophysiology of the nerve injury from lower third molar surgery. Surgery remains the most promising treatment in moderate-to-severe nerve injuries. There are limitations in the current treatment methods and full recovery is not commonly achievable. It is better to prevent nerve injury than to treat with unpredictable results. Coronectomy has been proved to be effective in reducing IAN injury and carries minimal long-term morbidity. New technologies, like the roles of erythropoietin and stem cell therapy, are being investigated for neuroprotection and neural regeneration. Breakthroughs in basic and translational research are required to improve the clinical outcomes of the current treatment modalities of third molar surgery-related nerve injury.
Keywords: Trigeminal nerve injuries, Inferior alveolar nerve, Lingual nerve, Third molar, Postoperative complications

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31 December 2019
Vol. 45
No. 6 pp. 301~378

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