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LINGUAL NERVE INJURIES DURING ORAL SURGERY PROCEDURES: VIEWS AND PERSPECTIVES
Abel Salgado* Rafael Guedes and Ana F. Vinha
Lingual nerve being one of the most important nerves within the oral cavity, it is very often injured during some oral surgery procedures. The clinical presentation of lingual nerve injury, its epidemiology, predisposing factors, and anatomy are explored to identify those patients at risk for developing neuropathic pain. Moreover, lingual nerve presents a variable anatomical location and is very often injured during mandibular third molar surgery due to trauma from an inferior alveolar nerve injection; incision, intubation in general anaesthesia; lingual flap retraction, bone removal and instrumentation; tooth sectioning; tooth elevation; and suturing. Due to its importance when it comes to guarantee the correct oral surgery procedures, this work aims to identify any factors that could aid the surgeon in preventing or minimizing the risk of lingual nerve injury during some oral surgery. The research which sustains this review was implemented on databases from PubMed (R), PMC and B-on, and the inclusion criteria were papers written from 2000 until 2019, that included clinical trials, case reports and revision articles, and whose subjects were humans and ought to have been written in English language. From the articles gathered, we were able to obtain a general vision of the frequency as well as of the severity of lingual nerve injuries and the most common ways of treating them. Oral surgery, namely third molar removal, is responsible for a high number of lingual nerve injuries. The piezosurgery may be advantageous when doing osteotomy and the raise or retraction of a lingual flap presents no advantage. The coronectomy emerged to avoid lingual nerve injuries. The time to repair the injured nerve should be as quickly as possible and the neurography presented the biggest success percentage, although in the lingual nerve case there may be an association with neuroma formation. Nevertheless, results should be interpreted with extreme caution because of the considerable heterogeneity of the data and the considerable influence of several anatomic and surgical variables that were closely related, but difficult to analyze independently.[Full Text Article]