Assessing recovery from lingual nerve injury

Key Points

• This study proposes a simplified method of assessing lingual nerve injuries subsequent to third molar surgery.

• Two point discrimination sensitivity and neuropathic area were the only conventional tests to reliably identify nerve injury.

• The subjective function score may identify patients at risk of permanent injury in the early post-operative period allowing expedition of their referral for specialist care.

Abstract

Objective To determine the sensitivity of conventional sensory assessment in monitoring lingual nerve recovery subsequent to third molar surgery and to evaluate if the assessment methods can be predictive of injury outcome.

Method A prospective case series of 94 patients presenting with lingual nerve injuries evaluated using objective mechanosensory and subjective methods during the recovery period of up to 12 months.

Results The conventional tests were often unable to diagnose the presence of injury due to variability and they were not predictive of outcome. As a result of this study, we are able to identify patients more likely to have permanent rather than temporary lingual nerve injury at four to eight weeks post injury, using patient reported subjective function. The subjective function test also minimises the requirements for specialist training or equipment providing an ideal method for general dental practice.

Conclusions The development of these simple subjective tests may enable us to identify which patients are at risk of permanent lingual nerve injuries in the early post injury phase, thus allowing expeditious therapy when indicated.

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