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IAN Paraesthesia Prognosis — ORE Part 1 MCQ

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ModerateOral SurgeryIAN Paraesthesia PrognosisORE Part 1

Six weeks after surgical removal of a right mandibular third molar, a patient reports persistent paraesthesia in the distribution of the right inferior alveolar nerve. No nerve exposure or visible nerve injury was recorded during the operation. Which prognosis is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Most cases improve over subsequent months, although a small proportion persist long term

Explanation lettering: C = shown as A · E = shown as B · D = shown as C · B = shown as D · A = shown as E

A is correct. At 6 weeks, IAN paraesthesia following third-molar surgery may still recover spontaneously over subsequent months; absence of a recognised intraoperative nerve injury also makes immediate transection less likely. In a prospective UK study, IAN impairment fell from 4.1% at 1 week to 0.7% at 2 years, so long-term sensory deficit is uncommon. B and E are too pessimistic because 6 weeks is not a threshold for permanence. C is incorrect: persistent altered sensation requires assessment, documentation and appropriate referral where indicated, not automatic microsurgery. D is incorrect because neural recovery is variable and often extends beyond the early postoperative period.

Reference: Jerjes W, et al. Permanent sensory nerve impairment following third molar surgery: a prospective study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2006. https://pubmed.ncbi.nlm.nih.gov/16997083/