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A Journal on Forensic Medicine
Minerva Medicolegale 2001 December;121(4): 259-66
Iatrogenic damage during extraction of impacted inferior third molar. A case of professional responsibility for the odontostomatologist
Cicciarello E., Fredduzzi L., Norcia G., Mariani G.
The authors discuss the problems caused by postoperative complications after the surgical extraction of an impacted inferior third molar, in particular involving lingual nerve lesions. They report the case of a patient with a embedded inferior molar III who subsequently underwent extraction. After extraction the patient presented symptoms of dysesthesia that failed to resolve spontaneously. A specialist neurological examination led to the diagnosis of iatrogenic damage to the left lingual nerve. The authors use this case as a starting point for an analysis of the medicolegal doctrine and jurisdiction relating to the professional liability of the odontostomatolgist. In the first place they highlight the ''contractual'' relationship between the doctor and his patient, based on the letter's complete trust in former, and they underline the importance of every stage of this relationship. They also outline the various forms of censurable conduct regarding the odontostomatologist's work, which may involve the diagnostic phase, the surgical and anesthesiological phase and also the therapeutic phase. Lastly, in the discussion the authors underline the anatomic characteristics of the trigeminal nerve from which, through the mandibular nerve, the lingual nerve is derived, and they describe the stages of the surgical procedure used to extract the impacted inferior third molar.