Mandibular alveolar neurovascular bundle injury associated with impacted third molar surgery.

Inferior alveolar neurovascular bundle (IANB) injury is one of the most common complications of third molar removal and involves important medicolegal issues. An accurate preoperative radiographic assessment of surgical difficulty is necessary to correctly plan the removal of impacted third molars and to estimate the risk of IANB injury. Therefore, the preoperative knowledge of the exact location of the third molar roots in relation to the mandibular canal is mandatory. A direct contact between the tooth and neurovascular bundle is suggested by a radiotransparent band across the roots of the impacted third molar on panoramic radiograph. We present the management of a patient with IANB damage associated with third molar surgery.

[1]  F. Roccia,et al.  Surgical Extraction of Deeply Horizontally Impacted Mandibular Second and Third Molars , 2010, The Journal of craniofacial surgery.

[2]  P. Boffano,et al.  Exposed inferior alveolar neurovascular bundle during surgical removal of a residual cyst. , 2010, The Journal of craniofacial surgery.

[3]  K. Yuasa,et al.  Assessment of the relationship between impacted mandibular third molars and inferior alveolar nerve with dental 3-dimensional computed tomography. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[4]  M. Malventi,et al.  Dental magnetic resonance imaging: study of impacted mandibular third molars. , 2009, Dento maxillo facial radiology.

[5]  S. Bergé,et al.  Position of the impacted third molar in relation to the mandibular canal. Diagnostic accuracy of cone beam computed tomography compared with panoramic radiography. , 2009, International journal of oral and maxillofacial surgery.

[6]  T. Dodson,et al.  Panoramic radiographic findings as predictors of mandibular nerve exposure following third molar extraction: digital versus conventional radiographic techniques. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[7]  Sujata Mohanty,et al.  Comparative efficacy of spiral computed tomography and orthopantomography in preoperative detection of relation of inferior alveolar neurovascular bundle to the impacted mandibular third molar. , 2009, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[8]  H. Hiratsuka,et al.  Clinical assessment of the relationship between the third molar and the inferior alveolar canal using panoramic images and computed tomography. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  B. Vasconcelos,et al.  Influence of the tooth section technique in alveolar nerve damage after surgery of impacted lower third molars. , 2008, International journal of oral and maxillofacial surgery.

[10]  B. Krishnan.  Kissing molars , 2008, BDJ.

[11]  A. Ladeinde,et al.  Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  T. Dodson,et al.  Preoperative computed tomography imaging in the management of impacted mandibular third molars. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  L. Kaban,et al.  Panoramic radiographic risk factors for inferior alveolar nerve injury after third molar extraction. , 2003, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[14]  H. Yuasa,et al.  Classification of surgical difficulty in extracting impacted third molars. , 2002, The British journal of oral & maxillofacial surgery.

[15]  E. Valmaseda-Castellón,et al.  Inferior alveolar nerve damage after lower third molar surgical extraction: a prospective study of 1117 surgical extractions. , 2001, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[16]  K. Gerlach,et al.  Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars. , 2001, International journal of oral and maxillofacial surgery.

[17]  C Lindh,et al.  Measurements of distances related to the mandibular canal in radiographs. , 1995, Clinical oral implants research.

[18]  J P Rood,et al.  The radiological prediction of inferior alveolar nerve injury during third molar surgery. , 1990, The British journal of oral & maxillofacial surgery.

[19]  S SUNDERLAND,et al.  A classification of peripheral nerve injuries producing loss of function. , 1951, Brain : a journal of neurology.

[20]  H. J. Seddon,et al.  THREE TYPES OF NERVE INJURY , 1943 .