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AbstractBackground: Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk ofsevere iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods: A retrospective chart review was performed for patients who had undergone microsurgical repair of lingualnerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction(Winter’s classification, Pell and Gregory’s classification). Ratios for the respective lingual nerve injury group data werecompared with the ratios of the respective data for the control group, which consisted of data collected from theliterature. The data for the control group included previous patients that encountered various complications during theremoval of the mandibular third molar. Results: The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients withiatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, witha mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups inage. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significantdifference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the controlgroups. Conclusion: Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may bea higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

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