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Background on Trigeminal Nerves
The trigeminal nerve is the cranial nerve responsible for sensation of the face, mouth, and tongue. Injury to the trigeminal nerve, is a known and accepted risk, of many oral surgery and dental procedures. The inferior alveolar nerve and lingual nerve are by far the most commonly injured branches of the trigeminal nerve. Trigeminal nerve injuries can lead to significant distress and alterations in daily life for patients. Fortunately, a large proportion of trigeminal nerve injury patients will resolve symptoms spontaneously. Unfortunately, 15-25% of patients will retain abnormal sensations and altered orofacial function for 3 or more months. Any injury/neuropathy persisting more than 1 year, is considered permanent, and may not respond to medical or surgical therapy.
Over the past 3 decades, there have been significant advances in understanding the mechanism of trigeminal nerve injuries, and great improvements have been made in surgical and nonsurgical treatment modalities. Early evaluation and timely microneurosurgery repair, within 3 to 6 months of injury, is recommended to help prevent chronic refractory neuropathy and associated symptoms. Recognition of injury and prompt referral gives trigeminal nerve injury patients the best chance of achieving improvement and recovery of sensory function.
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Most Common Causes of Trigeminal Nerve Injuries
- Third Molar Removal/Dentoalveolar Surgery
- Dental Implant Surgery
- Endodontic/Root Canal Therapy
- Local Anesthetic Injection
- Facial Trauma
- Corrective Jaw/Orthognathic Surgery
- Reconstructive and Cosmetic Jaw/Facial Surgery
- Jaw/Facial Pathology Surgery
- Salivary Gland Surgery