Lingual flap protection during third molar surgery: a literature review

The purpose of this review was to analyze how the retraction and protection of lingual flap (LF+) could influence the incidence of lingual nerve injury (LNI) during third molar extraction, as compared with protocols that do not involve handling of lingual tissue (LF). A literature review was performed from the Medline and Scopus medical databases, using the keywords lingual nerve and third molar surgery. From the selected articles, the mean values for transitory and permanent LNI's incidence were elaborated, taking into account the group treated with LF+ technique and the group treated with LF technique. Of 480 articles, 11 studies were included in the review. The LF+ group counted 3,866 surgeries and it resulted in a transitory LNI's mean incidence of 2.98 ± 0.03% and a mean incidence of 0.1 ± 0.003% for permanent LNI. The LF group counted 5,938 surgeries with, respectively, 1.92 ± 0.02 and 0.49 ± 0.006% of transitory and permanent LNI's incidence mean values. The results of this study suggest that the application of LF+ techniques reduces the risk of damage and injuries of lingual nerve.