Background: Iatrogenic trigeminal nerve injuries, particularly of the inferior alveolar and lingual nerves, represent a severe and disabling complication of dental procedures such as third molar extractions, implant placement, and endodontic treatment. While up to 90% of such injuries are transient, 10–18% become permanent if symptoms persist beyond six months. The primary pathogenetic mechanism is compression-ischemic syndrome within rigid anatomical canals, where post-traumatic edema leads to axonal hypoxia and demyelination.

Purpose: To improve treatment efficacy and reduce rehabilitation time in patients with iatrogenic trigeminal nerve injuries by implementing an early pathogenetic therapy algorithm combining anti-exudative intervention with modern physiotherapeutic methods.

Methods: A retrospective and prospective analysis was conducted on 60 patients with iatrogenic injuries to the inferior alveolar and lingual nerves. The main group (n=50) received complex pathogenetic therapy including early anti-edematous agents (glucocorticosteroids, venotonics) and physiotherapeutic methods (low-level laser therapy, magnetotherapy) within 24–72 hours post-injury. The comparison group (n=10) received standard treatment limited to B-complex vitamins and NSAIDs.

Results: Complete sensory recovery was achieved in 72% of the main group versus 30% of the comparison group. Mean recovery time was 3–4 months in the main group compared to 6–8 months in the comparison group. Chronic neuropathic pain developed in only 8% of the main group versus 50% of the comparison group. Early dexamethasone administration reduced paresthesia resolution time by 4–6 days and decreased permanent neuropathy risk by nearly 46%.

Conclusion: Early initiation of anti-edematous therapy combined with physiotherapeutic methods significantly enhances treatment efficacy, shortens rehabilitation periods, and minimizes the risk of chronic neurological complications following iatrogenic trigeminal nerve injuries.

Iatrogenic trigeminal nerve injury, inferior alveolar nerve, lingual nerve

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