Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures.

UNLABELLED: This article aims to review current hypotheses on the aetiology and prevention of inferior alveolar nerve (IAN) injuries in relation to dental procedures. The inferior alveolar nerve can be damaged during many dental procedures, including administration of local anaesthetic, implant bed preparation and placement, endodontics, third molar surgery and other surgical interventions. Damage to sensory nerves can result in anaesthesia, paraesthesia, pain, or a combination of the three. Pain is common in inferior alveolar nerve injuries, resulting in significant functional problems. The significant disability associated with these nerve injuries may also result in increasing numbers of medico-legal claims. Many of these iatrogenic nerve injuries can be avoided with careful patient assessment and planning. Furthermore, if the injury occurs there are emerging strategies that may facilitate recovery. The emphasis of this review is on how we may prevent these injuries and facilitate resolution in the early post surgical phase. CLINICAL RELEVANCE: It is imperative that dental practitioners are aware of the significant disability associated with iatrogenic nerve injuries and have an awareness of risk factors relating to inferior alveolar nerve injury. By understanding the risk factors and modification of intervention as a result, more of these injuries will be prevented.