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Published in: Clinical Oral Investigations 7/2019

01-07-2019 | Original Article

Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study

Authors: Assis Filipe Medeiros Albuquerque, Eduardo Costa Studart Soares, Paulo Goberlânio de Barros Silva, Barbara Betty de Lima, Francisco Samuel Rodrigues Carvalho, Thyciana Rodrigues Ribeiro, Davi de Sá Cavalcante, Fábio Wildson Gurgel Costa

Published in: Clinical Oral Investigations | Issue 7/2019

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Abstract

Objective

This study aimed to prospectively observe gustatory and neurosensory alterations following surgical removal of mandibular third molars.

Material and methods

A prospective clinical study was conducted with patients who required mandibular third molar extraction, recruited from the Division of Oral and Maxillofacial Surgery at the Federal University of Ceará (Brazil). Age, sex, and radiographic signs were recorded. The outcome variables were the presence or absence of gustatory and neurosensory alterations. The patients were observed preoperatively and at 7, 30, 90, and 180 days postoperatively by using gustatory and neurosensory tests.

Results

The response to sweet (p = 0.509) and sour (p = 0.078) stimulus did not alter significantly over time. The salty threshold significantly increased from the preoperative to 7- and 30-day postoperative periods, returning to baseline values at 90 days postoperatively (p = 0.038). The bitter threshold increased significantly from the preoperative to 7-day postoperative period, returning to baseline values at 30 days after surgery (p < 0.001). Regarding neurosensory evaluation, there was an altered response to stimulus at 7 days postoperatively in specific studied areas, returning to baseline values 30 days after surgery (p < 0.05).

Conclusion

The present study shows that mandibular third molar removal was associated with slight sensory disturbances related to mechanical, tactile, and gustatory perception. Regarding the recovery period, all patients returned to normal function without intervention, over a period ranging from 30 to 90 days.

Clinical relevance

This study highlighted the importance of a sensory evaluation following removal of third molars, notably regarding mechanical perception and gustatory threshold assessment.
Literature
1.
go back to reference Shepherd JP, Brickley M (1994) Surgical removal of third molars. BMJ 309(6955):620–621CrossRef Shepherd JP, Brickley M (1994) Surgical removal of third molars. BMJ 309(6955):620–621CrossRef
3.
go back to reference Blondeau F, Daniel NG (2007) Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc 73(4):325PubMed Blondeau F, Daniel NG (2007) Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc 73(4):325PubMed
5.
go back to reference Renton T, Thexton A, Hankins M, McGurk M (2003) Quantitative thermosensory testing of the lingual and inferior alveolar nerves in health and after iatrogenic injury. Br J Oral Maxillofac Surg 41(1):36–42CrossRef Renton T, Thexton A, Hankins M, McGurk M (2003) Quantitative thermosensory testing of the lingual and inferior alveolar nerves in health and after iatrogenic injury. Br J Oral Maxillofac Surg 41(1):36–42CrossRef
8.
go back to reference Miloro M, Repasky M (2000) Low-level laser effect on neurosensory recovery after sagittal ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89(1):12–18CrossRef Miloro M, Repasky M (2000) Low-level laser effect on neurosensory recovery after sagittal ramus osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89(1):12–18CrossRef
11.
go back to reference Westermark A, Englesson L, Bongenhielm U (1999) Neurosensory function after sagittal split osteotomy of the mandible: a comparison between subjective evaluation and objective assessment. Int J Adult Orthodon Orthognath Surg 14(4):268–275PubMed Westermark A, Englesson L, Bongenhielm U (1999) Neurosensory function after sagittal split osteotomy of the mandible: a comparison between subjective evaluation and objective assessment. Int J Adult Orthodon Orthognath Surg 14(4):268–275PubMed
12.
go back to reference Harvey WS, Phillips CL, Essick GK (2001) Neurosensory impairment and patient perception of recovery following orthognathic surgery [abstract]. J Dent Res 80(1_suppl):178 Harvey WS, Phillips CL, Essick GK (2001) Neurosensory impairment and patient perception of recovery following orthognathic surgery [abstract]. J Dent Res 80(1_suppl):178
17.
go back to reference Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47PubMed Dal Pont G (1961) Retromolar osteotomy for the correction of prognathism. J Oral Surg Anesth Hosp Dent Serv 19:42–47PubMed
19.
go back to reference Shafer DM, Frank ME, Gent JF, Fischer ME (1999) Gustatory function after third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87(4):419–428CrossRef Shafer DM, Frank ME, Gent JF, Fischer ME (1999) Gustatory function after third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87(4):419–428CrossRef
21.
go back to reference Ridaura-Ruiz L, Figueiredo R, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C (2012) Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study. Med Oral Patol Oral Cir Bucal 17(5):e759–e764CrossRef Ridaura-Ruiz L, Figueiredo R, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C (2012) Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study. Med Oral Patol Oral Cir Bucal 17(5):e759–e764CrossRef
22.
go back to reference Pell GJ, Gregory BT (1933) Impacted mandibular third molars: classification and modified techniques for removal. Dent Digest 39:330–338 Pell GJ, Gregory BT (1933) Impacted mandibular third molars: classification and modified techniques for removal. Dent Digest 39:330–338
23.
go back to reference Winter GB (1926) Principles of exodontia as applied to the impacted mandibular third molar; a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. American Medical Book Company, St. Louis Winter GB (1926) Principles of exodontia as applied to the impacted mandibular third molar; a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. American Medical Book Company, St. Louis
24.
go back to reference Costa FWG, Fontenele EHL, Bezerra TP, Ribeiro TR, Carneiro BGDS, Soares ECS (2013) Correlation between radiographic signs of third molar proximity with inferior alveolar nerve and postoperative occurrence of neurosensory disorders: a prospective, double-blind study. Acta Cir Bras 28:221–227CrossRef Costa FWG, Fontenele EHL, Bezerra TP, Ribeiro TR, Carneiro BGDS, Soares ECS (2013) Correlation between radiographic signs of third molar proximity with inferior alveolar nerve and postoperative occurrence of neurosensory disorders: a prospective, double-blind study. Acta Cir Bras 28:221–227CrossRef
26.
go back to reference Bartoshuk L (1989) Clinical evaluation of the sense of taste. Ear Nose Throat J 68(4):331–337PubMed Bartoshuk L (1989) Clinical evaluation of the sense of taste. Ear Nose Throat J 68(4):331–337PubMed
27.
go back to reference Davidson TM, Murphy C (1997) Rapid clinical evaluation of anosmia. The alcohol sniff test. Arch Otolaryngol Head Neck Surg 123(6):591–594CrossRef Davidson TM, Murphy C (1997) Rapid clinical evaluation of anosmia. The alcohol sniff test. Arch Otolaryngol Head Neck Surg 123(6):591–594CrossRef
28.
go back to reference Kamath S, Booth P, Lad TE, Kohrs MB, McGuire WP (1983) Taste thresholds of patients with cancer of the esophagus. Cancer 52(2):386–389CrossRef Kamath S, Booth P, Lad TE, Kohrs MB, McGuire WP (1983) Taste thresholds of patients with cancer of the esophagus. Cancer 52(2):386–389CrossRef
29.
go back to reference Perros P, MacFarlane TW, Counsell C, Frier BM (1996) Altered taste sensation in newly-diagnosed niddm. Diabetes Care 19(7):768–770CrossRef Perros P, MacFarlane TW, Counsell C, Frier BM (1996) Altered taste sensation in newly-diagnosed niddm. Diabetes Care 19(7):768–770CrossRef
31.
go back to reference Costa FW, Soares EC, Esses DF, Silva PG, Bezerra TP, Scarparo HC, Ribeiro TR, Fonteles CS (2015) A split-mouth, randomized, triple-blind, placebo-controlled study to analyze the pre-emptive effect of etoricoxib 120 mg on inflammatory events following removal of unerupted mandibular third molars. Int J Oral Maxillofac Surg 44(9):1166–1174. https://doi.org/10.1016/j.ijom.2015.06.012 CrossRefPubMed Costa FW, Soares EC, Esses DF, Silva PG, Bezerra TP, Scarparo HC, Ribeiro TR, Fonteles CS (2015) A split-mouth, randomized, triple-blind, placebo-controlled study to analyze the pre-emptive effect of etoricoxib 120 mg on inflammatory events following removal of unerupted mandibular third molars. Int J Oral Maxillofac Surg 44(9):1166–1174. https://​doi.​org/​10.​1016/​j.​ijom.​2015.​06.​012 CrossRefPubMed
32.
go back to reference Albuquerque AFM, Fonteles CSR, do Val DR, Chaves HV, Bezerra MM, Pereira KMA, de Barros Silva PG, de Lima BB, Soares ECS, Ribeiro TR, Costa FWG (2017) Effect of pre-emptive analgesia on clinical parameters and tissue levels of TNF-alpha and IL-1beta in third molar surgery: a triple-blind, randomized, placebo-controlled study. Int J Oral Maxillofac Surg 46(12):1615–1625. https://doi.org/10.1016/j.ijom.2017.05.007 CrossRefPubMed Albuquerque AFM, Fonteles CSR, do Val DR, Chaves HV, Bezerra MM, Pereira KMA, de Barros Silva PG, de Lima BB, Soares ECS, Ribeiro TR, Costa FWG (2017) Effect of pre-emptive analgesia on clinical parameters and tissue levels of TNF-alpha and IL-1beta in third molar surgery: a triple-blind, randomized, placebo-controlled study. Int J Oral Maxillofac Surg 46(12):1615–1625. https://​doi.​org/​10.​1016/​j.​ijom.​2017.​05.​007 CrossRefPubMed
35.
go back to reference Lehman CD, Bartoshuk LM, Catalanotto FC, Kveton JF, Lowlicht RA (1995) Effect of anesthesia of the chorda tympani nerve on taste perception in humans. Physiol Behav 57(5):943–951CrossRef Lehman CD, Bartoshuk LM, Catalanotto FC, Kveton JF, Lowlicht RA (1995) Effect of anesthesia of the chorda tympani nerve on taste perception in humans. Physiol Behav 57(5):943–951CrossRef
36.
go back to reference Pogrel MA, Renaut A, Schmidt B, Ammar A (1995) The relationship of the lingual nerve to the mandibular third molar region: an anatomic study. J Oral Maxillofac Surg 53(10):1178–1181CrossRef Pogrel MA, Renaut A, Schmidt B, Ammar A (1995) The relationship of the lingual nerve to the mandibular third molar region: an anatomic study. J Oral Maxillofac Surg 53(10):1178–1181CrossRef
39.
go back to reference Bartoshuk LM, Gent J, Catalanotto FA, Goodspeed RB (1983) Clinical evaluation of taste. Am J Otolaryngol 4(4):257–260CrossRef Bartoshuk LM, Gent J, Catalanotto FA, Goodspeed RB (1983) Clinical evaluation of taste. Am J Otolaryngol 4(4):257–260CrossRef
43.
go back to reference Robinson PP, Smith KG, Johnson FP, Coppins DA (1992) Equipment and methods for simple sensory testing. Br J Oral Maxillofac Surg 30(6):387–389CrossRef Robinson PP, Smith KG, Johnson FP, Coppins DA (1992) Equipment and methods for simple sensory testing. Br J Oral Maxillofac Surg 30(6):387–389CrossRef
44.
go back to reference de Beukelaer JG, Smeele LE, van Ginkel FC (1998) Is short-term neurosensory testing after removal of mandibular third molars efficacious? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85(4):366–370CrossRef de Beukelaer JG, Smeele LE, van Ginkel FC (1998) Is short-term neurosensory testing after removal of mandibular third molars efficacious? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85(4):366–370CrossRef
45.
go back to reference Ghali GE, Epker BN (1989) Clinical neurosensory testing: practical applications. J Oral Maxillofac Surg 47(10):1074–1078CrossRef Ghali GE, Epker BN (1989) Clinical neurosensory testing: practical applications. J Oral Maxillofac Surg 47(10):1074–1078CrossRef
46.
go back to reference Zuniga JR, Meyer RA, Gregg JM, Miloro M, Davis LF (1998) The accuracy of clinical neurosensory testinf for nerve injury diagnosis. J Oral Maxillofac Surg 56(1):2–8CrossRef Zuniga JR, Meyer RA, Gregg JM, Miloro M, Davis LF (1998) The accuracy of clinical neurosensory testinf for nerve injury diagnosis. J Oral Maxillofac Surg 56(1):2–8CrossRef
49.
go back to reference Nørholt SE, Aagaard E, Svensson P, Sindet-Pedersen S (1998) Evaluation of trismus, bite force, and pressure algometry after third molar surgery: a placebo-controlled study of ibuprofen. J Oral Maxillofac Surg 56(4):420–427CrossRef Nørholt SE, Aagaard E, Svensson P, Sindet-Pedersen S (1998) Evaluation of trismus, bite force, and pressure algometry after third molar surgery: a placebo-controlled study of ibuprofen. J Oral Maxillofac Surg 56(4):420–427CrossRef
Metadata
Title
Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study
Authors
Assis Filipe Medeiros Albuquerque
Eduardo Costa Studart Soares
Paulo Goberlânio de Barros Silva
Barbara Betty de Lima
Francisco Samuel Rodrigues Carvalho
Thyciana Rodrigues Ribeiro
Davi de Sá Cavalcante
Fábio Wildson Gurgel Costa
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 7/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-02798-5

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