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Lower Third Molar Surgery

 

The third molars are commonly referred to as the wisdom teeth. Their failure to erupt into the mouth often causes infection in the gums and food trap leading to decay, pain and swelling. Wisdom teeth extractions are the most common surgeries performed by dental surgeons. In our Dental Centre, more than 50 wisdom teeth are removed daily!

Inferior Dental Nerve Paraesthesia After Lower Third Molar Surgery

One of the risks of wisdom teeth surgery is the potential injury to the inferior dental nerves. The inferior dental nerve provides sensation to the chin, lower lip and teeth in the lower jaw. Injury to this nerve can result in the temporary or permanent, partial or complete loss in sensation in the areas supplied by the nerve.

The degree of risk is in part dependent on the anatomical location of the nerves in relation to the wisdom tooth. A clinical examination with x-rays is necessary to provide an indication of the potential of such an injury.

In KTPH, the average incidence of post-operative inferior dental nerve paraesthesia recorded at first postoperative review (about 7 to 10 days after the operation) is about 0.9%. This is comparable to several studies citing incidences of 1 to 5%1. A reduction in the incidence may imply an improvement of surgical technique, while an increase in incidence may mean an increase in the complexity of cases presented to the clinic. About 40% of these recovered completely.

Figure 1: Inferior Dental Nerve Paresthesia After Lower Third Molar Surgery


Post-operative Infection after Lower Third Molar Surgeries

Infection after wisdom teeth surgery can develop in the early or late post-operative period. In KTPH, the average rate of incidence of post-operative infection following wisdom teeth surgeries is about 0.2%. Post-operative infection rates reported in the literature range from 0.8% to 4.2%2.

Figure 2: Post-operative Infection After Lower Third Molar Surgery


References:

1. White Paper on Third Molar Data 2007. American Association of Oral and Maxillofacial Surgeons

2. Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral and Maxillofacial Surgery Clinics of North America 2007 Feb: 19(1):117-28