Lower third molar inclusion associated with paraesthesia: A case report

Di Lauro,Alessandro Espedito; Boariu,Marius; Sammartino,Pasquale; Scotto,Fabio; Gasparro,Roberta; Stratul,Stefan-Ioan; Rusu,Darian; Roman,Alexandra; Surlin,Petra; Solomon,Sorina

doi:10.3892/etm.2021.10258

Lower third molar inclusion associated with paraesthesia: A case report

Authors:
- Alessandro Espedito Di Lauro
- Marius Boariu
- Pasquale Sammartino
- Fabio Scotto
- Roberta Gasparro
- Stefan-Ioan Stratul
- Darian Rusu
- Alexandra Roman
- Petra Surlin
- Sorina Solomon
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Affiliations: Department of Oral Surgery, University of Naples Federico II, I‑80131 Napoli, Italy, Department of Endodontics, Faculty of Dental Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania, Department of Periodontology, Faculty of Dental Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, 300041 Timisoara, Romania, Department of Periodontology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400000 Cluj‑Napoca, Romania, Department of Periodontology, University of Craiova, 200349 Craiova, Romania, Department of Periodontology, ‘Gr. T. Popa’ University of Medicine and Pharmacy, 700020 Iasi, Romania
Published online on: June 3, 2021 https://doi.org/10.3892/etm.2021.10258
Article Number: 826
Copyright: © Di Lauro et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

When lower third molar inclusion is associated with neurosensorial complications, the treatment of choice is its surgical avulsion. One of these complications, that may be the most alarming during a first medical examination, is hemi‑lip paraesthesia, that can appear in the presence of several mandibular lesions. This is a report of a rare clinical case in which paraesthesia was linked to the closeness between the root block of the dental element and the mandibular canal, which houses the neurovascular trunk of the lower mandibular nerve. A 64 year‑old male Caucasian patient, presented with the chief complaint of past periodic inflammatory events in the retromolar region of the oral cavity and hemi‑lip paraesthesia. Upon local clinical and radiological examination, a lower left third molar with class 3 position C inclusion was incriminated. The medical history of the patient revealed well compensated diabetes mellitus type II, and pharmacologically controlled hypertension. The tooth was surgically removed using piezoelectric instruments. Before and after surgery, three types of tests (tactile, pain and thermal sensitivity) were carried out to delimit the area affected by paraesthesia. At 7 days, the area of hypoesthesia of the hemi‑lip was significantly reduced. Further improvement in tactile and thermal sensitivity occurred in subsequent follow‑up, at 1 and 3 months, postoperatively. This clinical case demonstrates that the surgical intervention performed with piezoelectric instruments prevented the damage of an important structure such as the lower mandibular nerve, and promoted regression of a contingent paraesthesia.

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