Outcome Assessment of Inferior Alveolar Nerve Microsurgery: A Retrospective Review


      This retrospective study was performed to assess the clinical outcome of patients who have undergone trigeminal nerve microsurgical repair of the inferior alveolar nerve.

      Materials and Methods

      This study includes all patients who underwent microsurgical repair of the inferior alveolar nerve at the University of Medicine and Dentistry of New Jersey from July 1, 1998 through June 30, 2003. Each patient underwent a thorough evaluation of sensory nerve function that included the type of injury, date of injury, and neurosensory testing. The evaluation was performed pre- and postoperatively to assess sensory improvement. Through chart review and quantitative statistical analysis, the outcome of inferior alveolar nerve microsurgical repair was assessed to ascertain which sensory variables were statistically significant in showing improvement from microsurgical procedures.


      Thirty-two patients underwent microsurgical repair of their inferior alveolar nerve injury by the same surgeon. The average period of time from initial nerve injury until primary surgical repair was 6.6 months. Four patients did not follow-up postoperatively and were excluded from the final data. Of the remaining 28 patients, mean follow-up period was 9.5 months. It was determined that 26 patients (92.9%) had statistically significant neurosensory improvement, with 14 reporting (50%) significant improvement, 12 patients (42.9%) with slight improvement, and 2 patients (7.1%) demonstrating no improvement. No statistical evidence was found to support that a decrease in time from injury to surgery had improved results in this limited patient population.


      Microsurgical repair provides an improvement in neurosensory function in patients that present with an inferior alveolar nerve injury.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ziccardi V.B.
        • Assael L.A.
        Mechanisms of trigeminal nerve injuries.
        Atlas Oral Maxillofac Surg Clin N Am. 2001; 9: 1
        • Sandstedt P.
        • Sorensen S.
        Neurosensory disturbances of the trigeminal nerve: A long-term follow-up of traumatic injuries.
        J Oral Maxillofac Surg. 1995; 53: 498
        • Venta I.
        • Lindqvist C.
        • Ylipaavalniemi P.
        Malpractice claims for permanent nerve injuries related to third molar removals.
        Acta Odontol Scand. 1998; 56: 193
        • Pogrel M.A.
        The results of microneurosurgery of the inferior alveolar and lingual nerve.
        J Oral Maxillofac Surg. 2002; 60: 485
        • Donoff R.B.
        Surgical management of inferior alveolar nerve injuries.
        J Oral Maxillofac Surg. 1995; 53: 1327
        • Meyer R.A.
        Applications of microneurosurgery to the repair of trigeminal nerve injuries.
        Oral Maxillofac Surg Clin N Am. 1992; 4: 405
        • Robinson P.
        • Smith K.G.
        A study on the efficacy of late lingual nerve repair.
        J Oral Maxillofacial Surg. 1996; 34: 96
        • Lam N.P.
        • Donoff R.B.
        • Kaban L.B.
        • et al.
        Patient satisfaction after trigeminal nerve repair.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 95: 535
        • Zuniga J.R.
        Trigeminal ganglion cell response to mental nerve transection and repair in the rat.
        J Oral Maxillofac Surg. 1999; 57: 427
        • Robinson P.P.
        • Loescher A.R.
        • Smith K.G.
        A prospective, quantitative study on the clinical outcome of lingual nerve repair.
        Br J Oral Maxillofac Surg. 2000; 38: 255
        • Rutner T.W.
        • Ziccardi V.B.
        • Janal M.N.
        Long-term outcome assessment for lingual nerve microsurgery.
        J Oral Maxillofac Surg. 2005; 63: 1145
        • Ziccardi V.B.
        • Zuniga J.R.
        Traumatic injuries of the trigeminal nerve.
        in: Fonseca R.J. Walker R.V. Betts N.J. Barber H.D. Powers M.P. (ed 3). Oral and Maxillofacial Trauma. Vol 2. Elsevier Saunders, St Louis, MO2005: 877-914
        • Carmichael F.A.
        • McGowan D.A.
        Incidence of nerve damage following third molar removal.
        Br J Oral Maxillofac Surg. 1992; 30: 78
        • Zuniga J.R.
        Surgical management of trigeminal neuropathic pain.
        Atlas Oral Maxillofac Surg Clin North Am. 2001; 9: 59
        • Gregg J.M.
        Surgical management of inferior alveolar nerve injuries (Part II): The case for delayed management.
        J Oral Maxillofac Surg. 1995; 53: 1330
        • Svane T.J.
        • Wolford L.M.
        • Milam S.B.
        • et al.
        Fascicular characteristics of the human inferior alveolar nerve.
        J Oral Maxillofac Surg. 1986; 44: 431