Actitud ante una posible parestesia del nervio dentario inferior tras la extracción quirúrgica del tercer molar inferior

Laburpena

Introduction: The paresthesia of the lower dental nerve is a well-known complication that can appear after surgical extraction of the lower third molars. The revised bibliography suggests performing a previous radiographic study to rule out predictive factors. Objective: The objective of this article was to make an evaluation and bibliographical review of the protocol for actions in this situation. Clinical case: The clinical case is presented of a male of 28 years of age, without prior medical history of interest, who went to the consultation referred by his dentist to proceed to the surgical extraction of the lower right third molar due to having presented recurrent acute serosal congestive pericoronitis, with pain that radiated towards the homolateral pharnyx. The radiological examination confirmed an intimate relation between the third molar and the lower dental conduct. As an expected complication, the anaesthesia of the right hemilabial area was produced, objectified by the mapping of the area. A treatment was prescribed of vitamin "B" complex every 8 hours for 21 days and the pertinent checkups were performed, achieving practically the total recovery of sensation. Discussion: The factors that present a greater incidence of nerve injuries in surgery of the lower cordal have been related to clinical aspects derived from surgical difficulty. The protocol of action after post-extraction parasthesia consists of two approach channels, with the non-surgical treatment the primary approach. We agree with some authors by considering that microsurgery is indicated at 4-6 months from the injury, although there is no known success rate for the lower alveolar nerve, although there is for the lingual nerve. Conclusion: The best treatment for the neurosensorial injuries of the lower dental nerve is the prevention by means of the prior radiological study and the performance of correct surgical technique.