Cranial Nerve Essay

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3.

A. Cranial nerve involvement can be broken down into two portions. The anterior 2/3 of the tongue are innervated by the Chorda Tympani branch of the Facial nerve which is carried by the lingual nerve which branches off the mandibular branch of the Trigeminal nerve. Sensory component of the anterior 2/3 is maintained by the lingual nerve. The posterior 1/3 of the tongue is innervated by the glossopharyngeal nerve which supplies both sensory and taste.
B. The human tongue contains multiple types of taste buds. These include:fungiform,foliate,circumvallate,filiform papillae. These papillae are located on different areas of the tongue and have different size and function. Fungiform are located on the dorsal tongue and innervated
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The most anatomical relevant factors are positioning of the wisdom teeth themselves. They may be full bony impactions where they haven’t erupted through the bone or soft tissue. These will be the most complicated and require removal of bone to access the wisdom teeth. There is also partial bony and soft tissue impaction which are significantly easier. The angle at which the teeth lay are also of great importance. They may be in several positions including distoangular, vertical, mesioangular and horizontal. Distoangular and horizontal are also significantly more difficult to remove and require more bone removal. For mandibular molars, we need to be aware of where the inferior alveolar nerve is located and also make sure that we do not perforate the lingual plate with our handpiece which protect us from damaging the lingual nerve. For maxillary molars, we must be aware of where the maxillary sinus is in relation to molars. We don’t want to apply to much apical pressure and displace the maxillary molars into the …show more content…
The most common complications that can occur include infection, alveolar osteitis, neuropathy and tmj complications. Infections can be managed quiet well through proper technique and thorough debridement and irrigation of the extraction site. Alveolar osteitis which is also knows as a dry socket may be avoided through proper post-operative instructions which will help to avoid clot removal from the extraction site. Neuropathy is best avoided by taking the time to do a good pre-operative evaluation of radiographs and noting location of important nerves. The vast majority of neuropathies will come from the inferior alveolar nerve. If the location of the nerve is kept in mind during the procedure the risk for complications decreases.

Sources
1. Hasan, L. S. (2015). Evaluation of Postoperative Complications after Surgical Removal of Impacted Lower Wisdom Teeth: a Prospective Study. Iraqi Dental Journal, 37(2), 62. doi:10.26477/idj.v37i2.45
2. 2. Sigron GR, Pourmand PP, Mache B, Stadlinger B, Locher MC. The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible. Swiss Dent J. 2014;124(10):1042-6, 1052-6. English, German.
3. Juodzbalys, G., & Daugela, P. (2013). Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification. Journal of Oral & Maxillofacial Research, 4(2), e1. http://doi.org/10.5037/jomr.2013.4201

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