Trigeminal Nerve Repair

Inferior alveolar and lingual nerve injuries are relatively uncommon, but they can occur. They are usually the result of common procedures performed by dentists and dental specialists. The most common procedure to cause injury to these nerves is the removal of wisdom teeth, especially impacted wisdom teeth. The risk of injury to the trigeminal nerve (inferior alveolar and lingual nerves) following wisdom tooth removal is very low but increases with the difficulty of the procedure, age of the patient, presence of infection, and other pathology located around the tooth.

Other procedures performed in the dental office also have a small risk of injury to these nerves. These include placement of dental implants, root canal procedures, Lower Jaw Orthognathic Surgery, injection of local anesthetics, and drainage of infections. Sometimes the removal or biopsy of phathologic entities or growths of the lower jaw can also lead to trauma to these nerves, which is sometimes unavoidable.

The good news is that the vast majority of these injuries resolve on their own and do not require surgical intervention. This spontaneous healing of the affected nerve can take a while, sometimes lasting over 3 months and, in some cases, over 1 year. The risk of a permanent nerve injury after one of the above mentioned procedure is very low.

The treatment of such injuries involves close monitoring of the progression of symptoms and hopefully improvement. This monitoring should start when the treating doctor is made aware of the nerve problem. If the doctor is not familiar in how to monitor these conditions, a referral to a Trigeminal Nerve Microsurgeon is recommended. Ideally such a referral should be made by the 3 month point after the injury occurred, if there is no progression of the symptoms to improved sensation. If the altered sensation is present over 1 year, without any intervention or improvement, the likelihood of surgical intervention benefiting the patient is significantly decreased. A series of neurologic examinations are necessary to decide which patient will benefit from surgery and who will not.

The main goal of Microsurgical intervention is to repair the nerve at the site of injury. This procedure is done with the use of high powered microscopes and special instruments specifically designed for these procedures.

How do I get started with trigeminal nerve repair?

Dr. Stein, Dr. Koslovsky, and our staff would be happy to discuss trigeminal nerve reapir with you. Please call 212-888-4760 or schedule an appointment online to arrange for a private consultation at our office.