Introduction :
Dental extractions are vital procedures done in clinical practice of a dentist.Sometimes,the injuries are unavoidable.One of the complication of an impacted teeth removal is neurosensory impairment.
How to verify via investigation methods before procedure?
It can be radiologically assessed by CBCT than OPG.
The radiological marker gives a detailed view between the mandibular molar & mandibular canal giving a better image quality of teeth and its surrounding structures ,as OPG gives a 2D image .
Can we detect the impairment by chair side?
Yes! It can be detected by non invasive methods.
How to evaluate it?
Various evaluation tests have been evolved.Few are,
Two point discrimination test
Blunt two pointed tips are placed on the patient skin with their eyes closed.The points are reduced gradually until they notice the sensation.
Brush stroke direction
Soft brush is moved against skin and direction of motion is identified from patient.
Contact detection test
Monofilament mounted on a end of plastic handle is held against skin.
Thermal testing
Two glass tubes of water :one being hot and one being cold is placed and the sensation is noted
Sharp blunt discrimination test
Probe blunt end with a rubber stopper is placed and the constant degree of skin indentation is noted.
Pin prick test
Repetition of ten touches with an explorer tip on the chin skin and the sensation is noted
Conclusion: Proper consent from patients and risks of the procedure must be well explained to the patient before starting the procedure.Nerve injury after an impacted molar removal can be avoided with accurate diagnosis & proper surgical methods and managed properly with error free evaluation along with medications.