Lingual nerve injury in third molar surgery: I. Observations on recovery of sensation with spontaneous healing

The aim of this study was to investigate the healing potential of damaged lingual nerves with some remaining function at least 3 months post injury. Forty-six patients were monitored at different time intervals after injury. A simple neurosensory examination included the perception of tactile, thermal stimuli and location of stimulus, as well as two-point discrimination, pain and the presence of a neuroma at the lesion site. Neurogenic signs and symptoms related to the injury and their variation over time were registered. Females were more often referred than males. Most lingual nerve injuries exhibited a significant potential for recovery, but only a few patients made a full recovery with absence of neurogenic symptoms. The recovery rate was highest during the first 6 months. Recovery was not influenced by gender, and only slightly by age. The presence of a neuroma was associated with a more severe injury. Patients should be monitored repeatedly for at least 3 months, and not operated on until neurosensory function no longer improves, and is less than what might be rendered by microsurgical repair. Through proper training and mastery of the surgical approach, every effort should be focused on sparing the lingual nerve, considering its proximity to the field of surgery.