Oral Surgery · patient case question
In pericoronitis around a mandibular third molar, referred pain most commonly follows which nerve?
Patient case: Third Molar Surgery and Its Complications
demo: 24-year-old female
chief: “The gum over my lower wisdom tooth is swollen and I can barely open.”
history: Smokes 10 cigarettes daily. Takes combined oral contraceptives. Poor oral hygiene.
meds: Combined oral contraceptive pill
findings: Partially erupted #17 with an inflamed, edematous operculum, purulent exudate on pressure, trismus, and tenderness. Extraction is planned. Four days after a previous extraction of #32, she developed severe radiating pain with an empty socket and exposed bone.
Show answer and explanation
Correct answer: C. The inferior alveolar nerve
- A. The lingual nerve supplies the lingual soft tissue and anterior tongue; it is at surgical risk but is not the usual pathway for referred pericoronitis pain.
- B. The greater palatine nerve is maxillary and irrelevant to a mandibular third molar.
- C. Correct. The inferior alveolar nerve runs immediately adjacent to the third molar region within the mandibular canal, so inflammation there produces the characteristic radiating pain along its distribution to the lower lip and chin.
- D. The long buccal nerve supplies buccal soft tissue over the molars, a much more limited territory.