Frequency of Lingual Nerve Damage During Mandibular Third Molar Surgery

Abstract

Background: The lingual nerve is anatomically vulnerable during mandibular third molar surgery because of its close relationship to the lingual cortical plate and posterior mandibular soft tissues. Injury to this nerve may lead to postoperative paraesthesia, dysesthesia, altered taste sensation, and impaired oral function. Objective: To determine the frequency of lingual nerve injury during mandibular third molar surgery and to examine its association with selected clinical and operative factors. Methods: This hospital-based cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery, Sandeman Provincial Hospital, Quetta, from March to August 2025. A total of 241 patients aged 18–65 years undergoing mandibular third molar extraction were included through consecutive enrollment. Demographic characteristics, inflammatory lesions, impaction-related findings, and operative details were recorded on a structured proforma. Postoperative lingual nerve injury was assessed clinically during follow-up visits. Data were analyzed in SPSS version 26.0 using descriptive statistics and chi-square testing, with p<0.05 considered statistically significant. Results: Lingual nerve injury was observed in 22 of 241 patients, giving a frequency of 9.13%. Pericoronitis was the most frequent associated lesion and showed a significant association with postoperative injury patterns overall (p=0.041). The source manuscript also reported statistically significant associations for impaction pattern (p=0.027) and bone cutting (p=0.001), although some subgroup totals require verification against the original dataset. Conclusion: Lingual nerve injury represents a clinically important complication of mandibular third molar surgery in this setting. Careful preoperative assessment, atraumatic surgical technique, and attention to local inflammatory and operative risk factors may help reduce avoidable neurosensory injury.