Relationship to Inferior Alveolar Nerve
Impacted mandibular third molars frequently have roots that are superimposed on the inferior alveolar canal on radiographs. Although the canal is usually on the buccal aspect of the tooth, it is in close proximity to the tooth. Therefore one of the potential sequelae of impacted thirdmolar removal is damage to or bruising of the inferior alveolar nerve. This usually results in some altered sensation (paresthesia or anesthesia) of the lower lip on the injured side. Although this altered sensation is usuallybrief (lasting only a few days), it may extend for weeks or months; on rare occasions it can be permanent. If the root ends of the tooth appear to e close to the inferior
alveolar nerve, the s urgeon must take special care to avoid injuring the nerve Fig. 9-35), which makes the procedure more difficult.