Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study
Introduction: The surgical removal of mandibular third molar (M3) teeth may result in a number of complications including pain, swelling, bleeding, alveolar osteitis or nerve dysfunction. Most of these problems are temporary, but in some cases, nerve paresthesia may become permanent and lead to func...
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2021-01-01
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doaj-2694e162616a46228a79f54bdc4dd6432021-05-05T11:26:14ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632021-01-011041712171710.4103/jfmpc.jfmpc_280_19Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective studySurendra N DawareRamdas BalakrishnaSuryakant C DeogadeYogesh S IngoleSushant M PatilDinesh M NaitamIntroduction: The surgical removal of mandibular third molar (M3) teeth may result in a number of complications including pain, swelling, bleeding, alveolar osteitis or nerve dysfunction. Most of these problems are temporary, but in some cases, nerve paresthesia may become permanent and lead to functional problems. Aims and Objectives: This study aims at measuring the clinical severity of pain, swelling, muscle trismus, infection, dry socket and any nerve injury-related paresthesia after surgical removal of M3. It also assesses the validity of the postoperative symptom severity and identifies the most frequent occurrences and postoperative complications. Material and Methods: The prospective study data was collected from 163 patients visiting the Department of Oral and Maxillofacial Surgery, for surgical extraction of impacted M3. Postoperative assessment was done after 1 week at the time of suture removal for pain, swelling, wound closure, postoperative bleeding, dry socket, infection, paresthesia and trismus. Pain intensity in the form of visual analogue scale, clinical swelling determination using thread measure, trismus assessment by differences in mouth opening, paresthesia/anesthesia by questioning about tongue, chin and lip sensibility and performing neurosensory tests like 2-point discrimination, pin prick and light touch. Patients with neurosensory disturbance were followed for 6 months. Results: This study confirmed the previously reported prevalence rates of neurological deficit and demonstrated 2% incidence of lingual nerve injury where no symptom lasted for more than 12 weeks. Inferior alveolar nerve paresthesia not reported in case series. Most of the patients reported with mild pain, mild swelling and trismus at seventh postoperative day at the time of suture removal. Conclusion: Although third molar surgery is a secure and low morbidity procedure, the risk of complications will always exist and it increases with increased surgical difficulty, hence the patient should always be educated about the risks and benefits of surgery in order to ensure adequate surgical management of impacted M3.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2021;volume=10;issue=4;spage=1712;epage=1717;aulast=Dawarecomplicationinferior alveolar nervelingual nervenerve injurythird molar surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Surendra N Daware Ramdas Balakrishna Suryakant C Deogade Yogesh S Ingole Sushant M Patil Dinesh M Naitam |
spellingShingle |
Surendra N Daware Ramdas Balakrishna Suryakant C Deogade Yogesh S Ingole Sushant M Patil Dinesh M Naitam Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study Journal of Family Medicine and Primary Care complication inferior alveolar nerve lingual nerve nerve injury third molar surgery |
author_facet |
Surendra N Daware Ramdas Balakrishna Suryakant C Deogade Yogesh S Ingole Sushant M Patil Dinesh M Naitam |
author_sort |
Surendra N Daware |
title |
Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study |
title_short |
Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study |
title_full |
Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study |
title_fullStr |
Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study |
title_full_unstemmed |
Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: A prospective study |
title_sort |
assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: a prospective study |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Family Medicine and Primary Care |
issn |
2249-4863 |
publishDate |
2021-01-01 |
description |
Introduction: The surgical removal of mandibular third molar (M3) teeth may result in a number of complications including pain, swelling, bleeding, alveolar osteitis or nerve dysfunction. Most of these problems are temporary, but in some cases, nerve paresthesia may become permanent and lead to functional problems. Aims and Objectives: This study aims at measuring the clinical severity of pain, swelling, muscle trismus, infection, dry socket and any nerve injury-related paresthesia after surgical removal of M3. It also assesses the validity of the postoperative symptom severity and identifies the most frequent occurrences and postoperative complications. Material and Methods: The prospective study data was collected from 163 patients visiting the Department of Oral and Maxillofacial Surgery, for surgical extraction of impacted M3. Postoperative assessment was done after 1 week at the time of suture removal for pain, swelling, wound closure, postoperative bleeding, dry socket, infection, paresthesia and trismus. Pain intensity in the form of visual analogue scale, clinical swelling determination using thread measure, trismus assessment by differences in mouth opening, paresthesia/anesthesia by questioning about tongue, chin and lip sensibility and performing neurosensory tests like 2-point discrimination, pin prick and light touch. Patients with neurosensory disturbance were followed for 6 months. Results: This study confirmed the previously reported prevalence rates of neurological deficit and demonstrated 2% incidence of lingual nerve injury where no symptom lasted for more than 12 weeks. Inferior alveolar nerve paresthesia not reported in case series. Most of the patients reported with mild pain, mild swelling and trismus at seventh postoperative day at the time of suture removal. Conclusion: Although third molar surgery is a secure and low morbidity procedure, the risk of complications will always exist and it increases with increased surgical difficulty, hence the patient should always be educated about the risks and benefits of surgery in order to ensure adequate surgical management of impacted M3. |
topic |
complication inferior alveolar nerve lingual nerve nerve injury third molar surgery |
url |
http://www.jfmpc.com/article.asp?issn=2249-4863;year=2021;volume=10;issue=4;spage=1712;epage=1717;aulast=Daware |
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