Investigating the Link Between Mandibular Third Molar Roots and Post-Extraction Nerve Complications

JAPAN: A recent Japanese study delves into the relationship between age-related changes in mandibular third molar roots and the potential occurrence of mental nerve paresthesia post tooth extraction. Published in the International Journal of Oral and Maxillofacial Surgery, the research explores critical factors contributing to this postoperative complication.

Root Morphology Examination through CBCT

Led by H. Sakakura and team, the study utilized dental cone beam computed tomography (CBCT) to scrutinize the root morphology of mandibular third molars. The research aimed to assess how age-related changes influence the likelihood of mental nerve paresthesia following tooth extraction. A total of 1216 patients who underwent mandibular third molar extractions were included, with a focus on 1534 teeth in 791 patients who had CBCT before the surgery.

Key factors evaluated in the study included age, the completeness of mandibular third molar root formation, periodontal ligament atrophy of the roots, hypercementosis, and deformation of the mandibular canal. 

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The analysis revealed that the completion of mandibular third molar root formation typically occurs between the ages of 19 and 30 years. Importantly, complete formation of the roots (P = 0.002) and deformation of the mandibular canal (P < 0.001) emerged as significant risk factors for mental nerve paresthesia.

Implications for Practice

The findings point to a crucial consideration for dental practitioners. According to the study, the risk of mental nerve paresthesia can be mitigated by performing third molar extractions before complete root formation. This insight highlights the potential for a proactive approach in dental procedures to reduce the likelihood of postoperative complications.

The research sheds light on a previously unexplored connection between mandibular third molar roots and mental nerve paresthesia. As the study identifies specific risk factors, it offers an opportunity for dental professionals to refine their extraction practices. By understanding the age-related changes influencing root morphology, practitioners may enhance patient safety and reduce the incidence of this serious postoperative complication.