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Lingual Perforation Risk — NDEB AFK MCQ

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ModerateOral SurgeryLingual Perforation RiskNDEB AFK

During the surgical extraction of a mandibular third molar, which structure is most at risk if the surgeon creates an excessively deep lingual bone perforation?

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Correct answer: C — Submandibular gland and/or sublingual space

Deep lingual bone perforation during mandibular third molar extraction risks displacing the root or instrument into the sublingual space (above the mylohyoid muscle) or submandibular space (below the mylohyoid muscle). The lingual plate in the third molar region is very thin (sometimes absent). Perforation can also injure the lingual nerve. Root displacement into the submandibular space requires surgical retrieval (submandibular approach). Haemorrhage from lingual periosteal vessels can track into the sublingual space, causing airway compromise from floor-of-mouth swelling.

Reference: Hupp – Contemporary Oral and Maxillofacial Surgery, 7th ed., 2019